Price transparency
Health Insurance Print

Florida’s New Healthcare Laws Protect Consumers and Promote Price Transparency

The Scoop

The Sunshine State’s new healthcare laws have patients saying goodbye to surprise medical bills and hello to price transparency. 

Overview

    •    Florida passed two healthcare laws on same day
    •    One law protects consumers from surprise out-of-network medical bills
    •    The other requires price transparency from health plans and providers

The Details

It’s the classic story. You undergo surgery at a hospital in your network, but little do you know, your anesthesiologist is out of network. And what soon follows is a surprise medical bill addressed to you. For Floridians, that’s no longer the case. A law recently passed protects patients from out-of-network balance billing. 

Under the new law, patients will only be responsible for their normal in-network cost-sharing requirements, and health plans and providers will have to negotiate payment through a dispute resolution process, which could be taken to court. Key takeaway? Thanks for leaving the kids out of mom and dad’s squabbles.  

Another victory for Florida consumers is the new law that requires price transparency from health plans and providers. The law requires payers to submit claims data to the state IF they want to participate in Florida's Medicaid program or the state employee health benefits program. 

The data collected will be used to create an online platform that allows consumers to research healthcare costs for bundled services provided in hospitals and ambulatory surgery centers. What’s more, prices are based on amounts providers receive from payers, not the original list prices. 

The law also requires hospitals and ambulatory surgery centers to list payment ranges for bundled services on their websites. Plus, they have to let patients know up front about the surgery center’s fees and the possibility of receiving care from out-of-network providers. And for the cherry on top, patients may request a good faith estimate of charges from providers for non-emergency services, which must be provided within 7 days otherwise providers will incur a penalty of $1,000 per day. Power to the people.

P.S. This move by the state of Florida could be a sign of things to come in other states across the nation.