Maine Hospital Association,

Procedure Charge Disclosure

Public Law 469, Section C-15, (22 MRSA, section 1718) requires that hospitals maintain a price list of the most common inpatient services and outpatient procedures provided by the hospital. The hospital is required to post, in a conspicuous place, a statement about the availability of the price list as required by this section. POSTING OF THE PRICE LIST IS NOT REQUIRED.

For inpatient services, the price list must include a per diem bed charge and an average charge for all ancillary charges for the 15 most common non-emergent services involving inpatient stays. If the per diem bed charge includes all ancillary charges for a procedure, no further information is required.

For outpatient non-emergent procedures for which an individual would not incur a bed charge, the price list must include average charges for the 20 most common surgical and diagnostic procedures, excluding laboratory services.

For emergency services, the price list must include average charges for facility and physician services according to the level of emergency services provided by the hospital and based on the time and intensity of services provided.

The law goes on to further state that the hospital shall provide its price list upon request of a consumer and that the price list may include a statement that actual charges may vary depending on individual need and other factors.

One of our concerns regarding this section of the Dirigo law is that a consumer advocacy group such as the Maine People's Alliance, or Consumers for Affordable Healthcare might visit hospitals to see if notices are posted and whether price lists are available. The intent of these visits could be to contact the media and others to complain that a hospital is out of compliance with the law.

Some hospitals have had questions regarding the section on outpatient procedures and have found that identifying the "20 most common surgical and diagnostic procedures" will likely result in a list with very few, if any, surgical procedures. Some hospitals have chosen to list 5-10 surgical procedures, along with the diagnostic procedures, to address this issue.

Other hospitals have asked whether posting the notice on their usual posting boards meets the requirement of "posting in a conspicuous place". The law is not specific in this regard, but most hospitals have taken this approach.

Most hospitals have decided to post a simple notice and format it similarly to other notices currently on the posting board.

There was lengthy Legislative debate regarding this provision, and the Maine Hospital Association pushed for the language that was ultimately included in the law, in order to make these lists as meaningful to the public as possible.

MHA Contact: David Winslow

Advocacy