MA Insurers, Hospitals Face Surcharges Under Cost-Control Bill

Other provisions of the 349-page bill that address health insurers include:

• A requirement to disclose out-of-pocket costs for proposed healthcare services in a readable and understandable format
• Extension of provisions of the small business health insurance legislation passed in 2010 that require the state Department of Insurance to review healthcare premium filings.
• Extends state DOI authority to help mitigate and stabilize large spikes in premium increases from year to year.
• Increases to 14% from 12% the minimum premium savings for tiered or selective network healthy products.
• Creates a smart-tiering plan where healthcare services are tiered and member cost sharing is based the tier placement of the services

Linzer told HealthLeaders Media that for payers, one upside of the legislation is the bill's recognition that the market strength of some providers is driving higher healthcare costs. The bill creates an 18-member special commission to review price variations among providers and to look at the feasibility of requiring insurers to separately contract with each location for a multi-location provider to reflect geographic differences in provider costs.

Martha Coakley, the state‘s attorney general, published in 2010 a report that linked the higher reimbursements received by some health facilities to their expanded markets and not necessarily to the care they delivered.

S 2400 faced limited legislative opposition. Gov. Deval Patrick (D) has until Aug. 10 to act on the bill, which he supports.