Florida Moves Closer to Requiring Healthcare Providers and Facilities to Provide Cost Estimates to Uninsured Patients

The Florida House of Representatives’ Healthcare Council recently voted unanimously to recommend the approval of landmark legislation that would require healthcare providers to provide each uninsured patient with a good faith estimate of charges for non-emergency treatment. The “Health Care Consumer’s Right to Information Act”, if adopted, would impose a monetary fine upon any healthcare facility or provider that fails to provide a good faith estimate.

The House of Representative’s staff analysis explains that the bill would “amend the current rights of patients… by requiring all non-state healthcare providers and facilities to provide to each uninsured person, prior to the provision of planned, non-emergency services, a reasonable estimate of charges for such services and information regarding the provider’s or facility’s charity care policies for which the uninsured person may be eligible.”

In particular, the bill would require the following with respect to such healthcare encounter estimates:

  • Upon request, a private licensed facility or provider must provide, an uninsured patient seeking planned, non-emergency care, with a written good faith estimate of anticipated healthcare charges.
  • Estimates must be reasonable and provided in good faith.
  • Estimates must be written in a language that is comprehensible to an ordinary layperson.
  • Estimates must be provided within 7 business days of the date upon which an uninsured patient explains that he is uninsured and requests an estimate.
  • Estimates may be based upon the average charges for the relevant diagnosis-related group or the average charges for the relevant procedure.
  • Nothing in the bill precludes a provider or facility from charging a higher amount than the estimate, so long as the estimate was reasonable and provided in good faith.
  • A provider’s or facility’s failure to render a timely estimate may result in a fine of $500 for each instance in which a provider or facility, as the case may be, fails to provide a timely estimate.

In addition, one version of the bill would require the State to publish information regarding the charges for the most common medical procedures on floridahealthfinder.com, an official State website.

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