Healthcare Price Transparency Becomes Law in Massachusetts

Trying to get an estimate of your cataract surgery before the procedure? Looking to compare your out-of-pocket costs for a hip replacement at different medical centers?

If you live in Massachusetts, health providers and health insurers are now required to provide cost estimates to patients who ask.

In August of 2012 Chapter 224, a major cost-containment law, passed in Massachusetts which requires physician practices, hospitals, and health insurers to respond to patient requests for cost information in two business days. 

Massachusetts residents have been able to obtain cost data from health insurers since October 2013. However, the process of requesting information from payers has been reportedly tedious for patients. As of January 1st, residents can now also request cost estimates from providers.

According to state law, the information providers must provide includes, but is not limited to, the allowed amount or charge of the admission, procedure or service, including the amount for any "facility fees" for services performed in a hospital or hospital-owned office. If the patient is insured, the provider can refer them to the health insurer's toll-free number and website to access cost information.

By October 2014, health insurers will be required to provide this information instantaneously.