HB 12-1257 Health Care & Provider Protections

House Bill 12-1257

Testimony to the House State, Veterans and Military Affairs Committee

Robert Semro, policy analyst

March 7, 2012

My name is Robert Semro, and I am a policy analyst with the Bell Policy Center. The Bell is a non-partisan, non-profit research and policy organization dedicated to expanding opportunity for all Coloradans.

The Bell Policy Center supports House Bill 1257. The primary focus of this legislation is transparency, disclosure and protection for consumers. Undisclosed billing practices may affect the accuracy of patient medical records and create unnecessary administrative costs.  In the worst-case scenario, they may even potentially provide cover for deceptive billing practices tied directly to health care benefits.  Furthermore, the issues that this legislation attempts to address are not merely hypothetical, as evidenced by the 9News investigative report of Sept. 14, 2011.

Consumers should have the opportunity to determine from their billing statement what they have been asked to pay for, whether that charge appears accurate and whether a third-party administrator was involved. This process should be no different in health care than in other markets.

This legislation advocates for the disclosure of the most basic billing information and the most basic consumer billing protections. Specifically, what parties are receiving compensation, the amount of that compensation and the relationship between the various parties. It would also prohibit a third-party administrator from altering or adding procedure codes for services to any claims submitted by the health care provider. Given the very technical nature of this legislation, real effort has been made to solicit input from the state's Department of Regulatory Agencies and the Division of Insurance in order to ensure that there are no practical, technical issues that might impede effective enforcement or unintended consequences that might result from specific bill language.

Given the cost of health care services, we need to make certain that all administrative costs are justifiable and that third-party administrator relationships are obvious to the consumer.  We would like to thank Rep. John Kefalas for sponsoring this legislation, and we urge this committee to support House Bill 1257. We thank you for the opportunity to testify today.