An Act To Clarify the Law Governing Public Disclosure of Health Care Prices
Be it enacted by the People of the State of Maine as follows:
Sec. 1. 22 MRSA §1718-A, as enacted by PL 2013, c. 332, §1 and affected by §3, is repealed.
Sec. 2. 22 MRSA §1718-B is enacted to read:
§ 1718-B. Consumer information regarding health care entity prices
This section applies to the disclosure of health care prices by a health care entity.
1. Definitions. As used in this section, unless the context otherwise indicates, the following terms have the following meanings.
A. "Frequently provided health care services and procedures" means those health care services and procedures that were provided by the health care entity at least 50 times in the preceding calendar year.
B. "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 patients for health care services and procedures. A health care entity does not include a pharmacy or a pharmacist.
2. Requirements. The following requirements apply to health care entities.
A. A health care entity shall have available to patients the prices of the health care entity's most frequently provided health care services and procedures. The prices stated must be the prices that the health care entity charges patients 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 descriptions of the services and procedures and the applicable standard medical codes or current procedural technology codes used by the American Medical Association.
B. A health care entity shall inform patients about the availability of prices for the most frequently provided health care services and procedures.
C. A health care entity shall prominently display in a location that is readily accessible to patients information on the price transparency tools available from the publicly accessible website of the Maine Health Data Organization established pursuant to chapter 1683 to assist consumers with obtaining estimates of costs associated with health care services and procedures.
A health care entity that does not routinely render services directly to patients in an office setting may satisfy this subsection by providing the information on its publicly accessible website.
Effective 90 days following adjournment of the 126th Legislature, Second Regular Session, unless otherwise indicated.