July 26, 2017

Inside the legal challenge to Ohio's price transparency law

Daily Briefing

    An Ohio law enacted two years ago that is intended to increase health care price transparency in the state still has not been enforced because of an ongoing legal challenge from health care providers.

    About the law

    Ohio's Healthcare Price Transparency Law would require providers to supply patients with a "good faith" estimate of how much non-emergency, elective health care services would cost individuals after accounting for health insurance. The law would mandate that providers must give the cost information to patients before they begin treatment. According to Kaiser Health News, the law was scheduled to take effect Jan. 1.

    Patient advocates have said the increased transparency could help patients shop around for health care services as a way to control their out-of-pocket costs. State Rep. Jim Butler (R), who authored the law, said, "If you really want patients to be empowered, they really need the information."

    Legal challenge details

    However, the Ohio Hospital Association and other provider groups—including the Ohio Physical Therapy Association, the Ohio Psychological Association, the Ohio State Medical Association, as well as the Ohio chapters of the American Academy of Pediatrics, the American College of Surgeons, and the American Osteopathic Association—in December 2016 filed a court injunction that successfully delayed the law's enforcement. According to KHN, the first court hearing in the lawsuit is scheduled to begin in August.

    The groups argued that the law's requirements are too broad and they would delay patient care by requiring physicians to make cost estimates before beginning treatment.

    According to KHN, provider groups in general oppose price transparency measures. For instance, the American Hospital Association on its website says insurers, not hospitals, are responsible for giving patients information on their out-of-pocket health care costs (Bluth, Kaiser Health News/Cincinnati Enquirer, 7/23).

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