TALLAHASSEE — Patients in Florida could soon get clearer information up front on what their care costs and whether their copay is more expensive than paying out of pocket, and then be able to more easily dispute those charges, if a bill that passed the Legislature becomes law.
And while sending a patient’s bill to debt collection would be less likely under the measure, hospitals would have less time to pursue the money once they take that step.
After the bill passed the Florida Senate on Thursday, Senate sponsor Jay Collins, a Tampa Republican, said in a statement that it “will go a long way to increase transparency so patients have a better understanding of costs, and protection from onerous debt collection practices.”
Senators unanimously voted for the price transparency bill, HB 7089, which had already unanimously passed the House on Monday. The provisions were priorities of the House, which like the Senate has long sought free-market solutions to bring down the high cost of health care.
The bill was the final holdout among the six pieces of legislation that make up the $1.1 billion “Live Healthy” package, the main priority this legislative session of Naples Republican and Senate President Kathleen Passidomo.
“The comprehensive Live Healthy proposals passed this session will help grow Florida’s health care workforce, increase access, and incentivize innovation, so Floridians can have more options and opportunities to live healthy here in the Sunshine State,” Passidomo said in a statement on Thursday.
The bill was postponed in the Senate on Wednesday as the two chambers drafted a final amendment to ensure it complied with impending federal regulations.
Collins presented the amended House bill to his full chamber Thursday evening. Collins’ amendment retained a requirement that hospitals give patients and their health insurers a timely cost estimate for their treatment but removed language that they provide it “upon scheduling” the service, and delayed implementation until related federal rules are finalized.
Currently, patients can get that estimate when they ask for one.
Similarly, Collins also delayed implementation of another key requirement that hospitals and insurers work together to give patients a detailed “advanced explanation of benefits” of what their care is likely to cost them in advance so as to align with anticipated federal regulations.
Florida Hospital Association lobbyist David Micah Jr. spoke out about the advanced explanation of benefits piece of Collins’ bill in the Senate Banking and Insurance Committee on Feb. 6, saying this part of the bill was already addressed in the federal 2022 No Surprises Act, but that the component had been delayed to allow hospitals more time to implement it.
“That’s a partnership … between us and the insurers, to move that information back and forth so that the patient can get that from the insurer prior to service,” Micah said. “That system actually doesn’t work yet. We don’t have it together.”
Live Healthy is meant to grow Florida’s health workforce, incentivize innovation, make prices more predictable and transparent, and the system better coordinated for patients, from primary care to disability services to behavioral health. Currently, hospitals have five years to pursue a medical debt once it has been sent to collections; under the bill they would have three years.
The bill also prohibits a hospital from taking an “extraordinary collection action” like selling a patient’s debt to a third party, e.g. collections, or placing a lien on their property before determining, among other things, whether the patient qualifies for financial assistance or when they are negotiating the bill in “good faith.”
The package doesn’t expand Medicaid, leaving an estimated 789,800 low-income Floridians still without health coverage, per the Kaiser Family Foundation. Florida is one of just 10 states that refuse to offer the mostly federally subsidized health insurance program to its working poor.
While the overall Live Healthy package was Passidomo’s initiative, the House contributed several of its own long-standing priorities, many of which were captured in the House measure the Senate passed on Thursday, including price transparency.
Since 2021, the federal government has required hospitals to “provide clear, accessible pricing information online about the items and services they provide.” But 41% of Florida hospitals are not complying with the rule, according to a report published last month by the nonprofit focused on health care price transparency, PatientRightsAdvocate.org.
Florida lawmakers are now adding similar price transparency provisions to state law. The measure requires hospitals to post either estimated prices for 300 common procedures like knee surgeries or a price estimator tool that complies with federal law so that patients may shop around for the best price.
“The thing about health care is you don’t know what things really cost. You go where you’re told, you pay what you’re told,” House Speaker Paul Renner said about the bill on Wednesday. “This idea is to simply marry up the boots on the ground that the state has along with what the federal government’s doing to give maximum transparency to patients about the cost.”
A previous version of the bill required insurers to create a shared-saving program, which is currently optional in Florida, so that patients could recoup some of the money they save their insurer by shopping around for cheaper care. Renner said the initiative was intended to further “bring down the cost of health care,” but lawmakers decided they didn’t “need that piece on the private side.”
Times/Herald Tallahassee bureau reporter Romy Ellenbogen contributed to this report.