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house Bill H.R. 876

Should Hospitals Be Required To Tell Medicare Patients How Much An Outpatient Stay Costs?

Argument in favor

Hospital care is expensive — and people have Medicare because they need help paying for it. If they are going to receive treatment that Medicare does not cover, they need to know so that they can plan accordingly.

bart's Opinion
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03/20/2015
Greater transparency around medical costs is critical to their reduction.
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John's Opinion
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03/16/2015
How is it that medical care seems to be the only thing that is sold without the consumer even knowing the cost? Let's keep costs out in the open where everyone can see them.
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FaithInJesus's Opinion
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03/16/2015
Hospitals are criminal in the way they charge for services without any upfront pricing. Why are the biggest profits in most communities coming from "nonprofit" hospitals?
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Argument opposed

Doctors order treatments for patients, because they are necessary, not to make money. Outpatients are designated as outpatients because doctors believe it’s medically necessary. No amount of notification will change that.

Elinor's Opinion
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03/17/2015
No healthcare worker or entity can give an exact amount of treatment costs. After all, no federal agency does that, but you who would support this bill expect all who do NOT work for the federal government to have a crystal ball for patients' out-of-pocket expenses. How many of you have NEVER run and/or owned a business? Given the inane proposed bills I see on Countable, about all of you fit into the category of knowing nothing about business and healthcare.
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jodide's Opinion
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05/24/2016
As a R.N. I would love to be able to vote for this, but the fact is it's impossible! Doctors, nurses, and other treatment providers are concerned with health and wellness, not so much cost. Obviously it's a factor, but it's likely the last thing focused on when trying to make somebody better. It'd be wonderful to be able to sign a consent for items possibly needed and their prices so the pt/consumer would be aware, but again, if the situation is urgent, emergent, or even unknown, this idea is simply not feasible.
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John's Opinion
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02/23/2016
Wheres the wellbeing of the patient fit into this plan? As with anything else sounds like a push for more insurance companies to justify cost! And make bigger profits. These profits are then funneled down to elected officials by way of lobbyists and election campaigns
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bill Progress


  • EnactedAugust 6th, 2015
    The President signed this bill into law
  • The senate Passed July 27th, 2015
    Passed by Voice Vote
      senate Committees
      Committee on Finance
  • The house Passed March 16th, 2015
    Roll Call Vote 395 Yea / 0 Nay
      house Committees
      Committee on Energy and Commerce
      Health
      Committee on Ways and Means
      Health
    IntroducedFebruary 11th, 2015

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What is House Bill H.R. 876?

This bill seeks to improve the information given to patients about the cost of their care. Under it, Medicare beneficiaries under outpatient care for more than 24 hours would receive a hospital notice of:

  • the difference between receiving care under outpatient observation and receiving care in a hospital and why the healthcare professionals made that choice;
  • the effect this decision would have on Medicare coverage or other cost-sharing mechanisms.


The bill does not require, but would allow the Secretary of the Department of Health and Human Services to require that patients or those acting on their behalf sign the notification to show that they’ve received it. It also requires that the notification be written in plain language, and that people who would prefer to receive it orally can do so.


Hospitals would have to give 36 hours notice after placing a person under this care. If the bill passes, healthcare facilities would have one year to fully comply with the new regulations.


Impact

People that qualify for Medicare; hospital outpatients under observation; doctors, nurses and other care providers; the Social Security Administration

Cost of House Bill H.R. 876

The CBO estimates that this bill would have no significant impact on the Federal budget over the next ten years.

More Information

In Depth:

This bill has bipartisan support, and amends the Social Security Act, signed in 1935.


Of Note:

If you’re in the hospital, you’re an inpatient, and if you aren’t, but are still receiving care, you’re an outpatient. Simple, right? Well, not really. You can still stay in the hospital as an outpatient if a doctor has you under observation — watching to see if you need to be admitted as an inpatient.


Currently, Medicare pays for twenty days in the hospital, but only if patients are there as “inpatients” for three. It does not cover on-site “outpatient” stays. This means that people who stay as outpatients can often get stuck with huge medical bills.


Media:

Co-Sponsoring Rep. Todd Young (R-IN) Press Release

CBO Cost Estimate

AARP (Context)

Summary by James Helmsworth

(Photo Credit: Flickr user Thirteen of Clubs)

AKA

NOTICE Act

Official Title

To amend title XVIII of the Social Security Act to require hospitals to provide certain notifications to individuals classified by such hospitals under observation status rather than admitted as inpatients of such hospitals.

    Greater transparency around medical costs is critical to their reduction.
    Like (62)
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    How is it that medical care seems to be the only thing that is sold without the consumer even knowing the cost? Let's keep costs out in the open where everyone can see them.
    Like (28)
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    Hospitals are criminal in the way they charge for services without any upfront pricing. Why are the biggest profits in most communities coming from "nonprofit" hospitals?
    Like (11)
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    Absolutely. The more knowledgeable a consumer is, the more informed his choices will be.
    Like (9)
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    How about knowing what all the healthcare costs are? Please still provide care, but at least let me know the price tag.
    Like (6)
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    If I'm going to pay for something then I have a right to know how much I'll be paying. Not simply hand over a blank check and say fill it in and let me know whenever you get around to it.
    Like (5)
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    All information like this should be readily visible and transparent.
    Like (5)
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    Health care prices are one thing we do not shop for in this country. This could lead to better use of healthcare $$ in the future.
    Like (4)
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    Some patients don't even know they are not an inpatient and that they will be charged. Tricky way for hospitals to not be fined for readmitting a patient
    Like (2)
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    Essential. The fear of a future mystery bill is enough to make someone sick.
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    It's only logical that if someone is paying for a service, then should know the price for said service.
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    People need to be informed about their medical care, and the disclosure of costs is a small but essential part of that. It can also lead to discussions about alternate therapies, drive down costs and allow people to not be blindsided into bankruptcy due to a medical emergency.
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    Cost transparency in healthcare is one overdue.
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    A hospital visit is expensive and people should know what they're costs are going to be so they can make an informed decision.
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    Transparency is always a good thing!
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    People have the right to know how they're being billed. This increased transparency could also be a step in meeting people where they're at when it comes to paying for medical care.
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    No healthcare worker or entity can give an exact amount of treatment costs. After all, no federal agency does that, but you who would support this bill expect all who do NOT work for the federal government to have a crystal ball for patients' out-of-pocket expenses. How many of you have NEVER run and/or owned a business? Given the inane proposed bills I see on Countable, about all of you fit into the category of knowing nothing about business and healthcare.
    Like (1)
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    I just got hit with this was released and went home and fekk several time..PT recommended that I go to an aftercare facility but because I was place on observation that was not possible..I now am having difficulty in breathing and am reluctant to go back...its because I have a dx that is poorly understood and am at the mercy of hospitalist system. I am now rethinking my hospital choices
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    Reasons stated
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    It is not fair for patients to be left with a huge bill without any sort of warning.
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