Legislation


AB 1066 – Wisconsin

Status: Inactive / Dead
Year Introduced: 2018
Link: http://docs.legis.wisconsin.gov/2017/related/proposals/ab1066

This bill changes the pricing disclosures required from certain health care providers and hospitals. Under current law, certain health care providers and hospitals are required to disclose, among other things, the median billed charge, which means the amount the health care provider or hospital charged, before any discount or contractual rate applicable to certain patients or payers was applied, during a time period set forth in the statutes, and calculated as described in the statutes. This bill requires health care providers and hospitals to disclose, instead of the median billed price, the lowest price accepted, which is defined in the bill as the lowest price a health care provider or hospital accepts as payment in full for a health care related product or service offered for sale to the public.

The bill also changes the amount of time health care providers and hospitals have to update certain charge information. Under current law, health care providers must annually update the document listing 1) the median billed charge, 2) the Medicare payment to the provider (if the health care provider is certified as a provider of Medicare), and 3) the average allowable payment from private, third-party payers, assuming no medical complications, for diagnosing and treating each of 25 conditions identified by the Department of Health Services for the health care provider’s type. Similarly, current law requires hospitals to update, every calendar quarter, the document listing 1) the median billed charge, 2) the average allowable payment under Medicare, and 3) the average allowable payment from private, third-party payers, assuming no medical complications, for inpatient care for certain diagnosis-related groups and for certain outpatient surgical procedures. This bill substitutes the lowest price accepted for the median billed charge and requires health care providers and hospitals to update the information on a continuous basis as information is available.


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