Price-transparency law for health care blocked

DAYTON— The state is appealing a judge’s decision to block a health-care transparency law that calls for sweeping changes to health-care billing but has never gone into effect.

Attorney General David Yost’s office filed an appeal Thursday, but his office said it has no information to share about the decision to appeal.

The law requires health care providers to give an up-front, good-faith estimate of the cost of care, unless it was an emergency.

The legislation was supported by state Rep. Jim Butler, R-oakwood, who said it provided consumers necessary information.

Medical-industry groups oppose it, calling it burdensome and unworkable.

Billing transparency has become a hot policy topic at both the federal and state level.

Thomas Campanella, a health care economist with Baldwin Wallace University, said that although he couldn’t weigh in on the lawsuit, in general hospitals and the insurance industry could be doing more to make prices transparent.

Although it might be cumbersome for providers to figure out how much a procedure costs after insurance, he said, this problem has been around for years, and more could have been done by now to make costs transparent if the providers and insurers felt more pressure to do so.

“If you don’t do anything about it, and you don’t adjust the systems, it will always be impractical,” Campanella said.

Hospitals and insurance companies typically agree to confidentiality clauses that prevent them from sharing the in-network prices they’ve negotiated, and although there are business reasons for confidentiality, it creates problems for patients wanting to understand their costs.

“In the middle of all this is the consumer, and the employer being penalized,” Campanella said.

The law being appealed was passed in 2016 as part of a larger workers’-compensation bill. However, it never went into effect.

The Kasich administration did not create the rules needed to implement the law, and several healthcare industry groups, including the Ohio Hospital Association and the Ohio State Medical Association, had sued in Williams County Common Pleas Court and won a temporary restraining order blocking the law.

The Ohio Hospital Association said hospitals “wish to empower patients to fully understand cost obligations and, quite aside from any law or regulation, are providing more information to patients.”

“OHA remains committed to working with other providers, payers and policymakers on price transparency, but state policy must be attainable, provide meaningful information to patients, and be written in a way that hospitals and other providers can comply with the law,” the association said.

In the February decision to approve a permanent injunction against the pricetransparency law, the judge noted that House Bill 52, where the pricetransparency language is found, was intended to make changes to workers’-compensation law and make appropriations for the Bureau of Workers’ Compensation.

The judge wrote that the entire legislative history of that bill had been about workers’ compensation, and when the bill passed both the House and Senate, it contained no reference to health-care price transparency. Then on June 25, 2015, with no hearings or prior introduction, an amendment with the price-transparency legislation was added.