An Act To Clarify the Law Governing Public Disclosure of Health Care Prices
Sec. 1. 22 MRSA §1718-A, first ¶, as enacted by PL 2013, c. 332, §1 and affected by §3, is amended to read:
Each A health care practitioner, as defined in section 1711-C, subsection 1, paragraph F, entity shall maintain a price list of the health care practitioner's entity's most frequently provided health care services and procedures. The prices stated must be the prices that the health care practitioner entity charges clients directly , when there is no insurance coverage for the services or procedures or when reimbursement by an insurance company is denied. The prices stated must be accompanied by a description of the service and the applicable standard medical codes listed by diagnosis code or current procedural technology code. For purposes of this section, "health care entity" means a health care practitioner, as defined in section 1711-C, subsection 1, paragraph F; a group of health care practitioners; or a health care facility, as defined in section 1711-C, subsection 1, paragraph D, that charges clients for health care services and procedures. For purposes of this section, "frequently provided health care services and procedures" means those health care services and procedures that were provided by the health care practitioner entity at least 50 times in the preceding calendar year. Health A health care practitioners entity shall inform clients about the availability of the price list and provide copies of the price list upon request. Health A health care practitioners entity shall make available written information on health claims data that may be obtained through the publicly accessible website of the Maine Health Data Organization established pursuant to chapter 1683. This section does not apply to pharmacists.
summary
This bill amends the law governing the public disclosure of health care prices. It:
1. Specifies that it is a health care entity that must maintain a price list and defines "health care entity" to mean a health care practitioner, a group of health care practitioners or a health care facility;
2. Clarifies the information that must be included with the price list; and
3. Eliminates the requirement that health care entities make available copies of the price list upon request.