State Rep. Harry A. Readshaw, a Democrat whose 36th Legislative District includes parts of Baldwin and Whitehall boroughs, has introduced legislation that would require medical facilities to reveal the cost of a procedure or medical test prior to a doctor ordering it for a patient.

Readshaw said that the proposal is the result of information brought to him by Dr. Joseph Rudolph, a physician in Allegheny County.

Rudolph brought to the attention of Readshaw many Pennsylvanians, including Medicare beneficiaries, who have been experiencing new, larger health insurance deductibles or are now participating in Health Savings Accounts (HSAs). Rudolph said that patients need to know the cost of services in order to maximize the value of their out-of-pocket health care costs.
 
"Now is the time for hospitals to display their prices in a uniform system," Rudolph said, "just as gasoline stations, grocery stores and other retailers display the cost of goods and services. Pennsylvanians must know what portion of their costs will be paid by their health insurance company in order to select the best value for their health insurance premium.

"The (proposed) Patient Medical Access and Affordability Act (Readshaw's House Bill 2179) will empower Pennsylvanians to save 50 percent or more on health care costs without any taxpayer subsidy."

House Bill 2179 would require medical providers to list all services, supplies and charges on a publicly accessible website. Likewise, health insurance providers would post a fee schedule for what it will pay for specific tests and procedures. An individual patient would be responsible for making up any differences in the cost for a specific item.

Facilities that would be governed by the legislation would include hospitals, long-term care facilities, outpatient diagnostic facilities, medical equipment providers, medical practices not owned by private practitioners, and outpatient surgical centers.

Medical providers exempt from the requirement would include physicians who are private practitioners, private-duty nurses, chiropractors, dentists, podiatrists and independent psychologists.

Patients covered by government-provided services such as Medicaid, Medicare or workers' compensation would not need to pay the difference between provider charges and the government allotment.

"My legislation would eliminate the mystery behind medical billing by allowing individuals the freedom to conveniently shop around," Readshaw said. "If they are considering an insurance provider, they would see how its reimbursement rate compares to others. If they, or a guardian, have a long-term care decision pending, they could much more easily get information that would help them in the selection."

The bill has been referred to the House Health Committee for consideration.

Thoughts on the bill? Share them in the comments section below.

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