SB 1543 Summary

• Requires hospitals, general medical surgical hospitals, specialized hospitals, critical access hospitals, emergency hospitals, and ambulatory surgical centers to submit cost and billing data to the State Department of Health beginning with the quarter ending September 30, 2017, and annually thereafter.

• Mandates facilities report total costs for the 100 most common medical procedures and 50 most common imaging procedures performed in outpatient settings, including related CPT and HCPCS codes.

• Requires facilities to provide average billing amounts to private insurers and average reimbursement amounts received from private insurers for each specified procedure.

• Obligates hospitals and ambulatory surgical centers to provide this information in writing to patients or legal guardians upon request and inform patients of their right to obtain such information at or soon after admission.

• Specifies that provided information does not constitute an invoice, contract, or contractual agreement and directs the State Board of Health to promulgate implementing rules; becomes effective November 1, 2016.