Todd Welter has some opinions when it comes to the upcoming Colorado State Bill HB19-1174 Out-Of-Network Health Care Services Provided To Covered Persons. Read it for yourself to see why he believes that the government should not be in the process of setting prices, and why health insurance companies should keep their patients’ best interest in mind by keeping prices low for the future.
Our very own Todd Welter has been invited to the Colorado State Senate hearing on HB19-1174 Out-Of-Network Health Care Services Provided To Covered Persons.
In his own words, “The government should not be in the business of setting prices, there are too many unintended consequences. A free and transparent market should set prices.”
This bill would require “health insurance carriers, health care providers, and health care facilities to provide patients covered by health benefit plans with information concerning the provision of services by out-of-network providers and in-network and out-of-network facilities; outlines the disclosure requirements and the claims and payment process for the provision of out-of-network services; requires the commissioner of insurance, the state board of health, and the director of the division of professions and occupations in the department of regulatory agencies to promulgate rules that specify the requirements for disclosures to customers, including the timing, the format, and the content and language in the disclosures; establishes the reimbursement amount for out-of-network providers that provider health care services to covered person at an in-network facility and for out-of-network providers or facilities that provider emergency services to covered persons; and creates a penalty for failure to comply with the payment requirements for out-of-network health care services.
Read the rest of the bill here. (PDF)
If the state government sets prices for out-of-network services the health plans will be encouraged to use this as a ceiling rate. Any provider who has a higher rate (specialists in rural areas, very unique services, new procedures, etc.) will simply get their contracts terminated allowing the payers to use the state imposed ceiling rate.
Please contact your government representatives and make your opinion known!