(1) (a) A health care facility shall make available to the public, in a single document, either electronically or by posting conspicuously on its website if one exists, the health care prices for at least:
The fifty most used, diagnosis-related group codes or other codes for in-patient healthcare services used by the health care facility for billing or, if those codes are not used, the codes under another coding system for in-patient health care services commonly used by the facility and accepted as a national standard for billing; and
The twenty-five most used out-patient CPT codes or health care services procedurecodes used for billing or, if those codes are not used, the codes under another coding system for out-patient health care services commonly used by the facility and accepted as a national standard for billing.
If a health care facility did not use fifty codes for in-patient health care services atleast eleven times in the previous twelve months or did not use twenty-five codes for out-patient health care services at least eleven times in the previous twelve months, the health care facility shall make available the health care price for only those most common in-patient and out-patient health care services or procedure codes that the health care facility used at least eleven times in the previous twelve months.
A health care facility shall include with the health care price provided pursuant tothis subsection (1) a plain English description of the service for which the health care price is provided.
The health care facility shall update the document as frequently as it deems appropriate, but at least annually.
(2) The health care facility shall include:
A disclosure specifying that the health care price for any given health care service isan estimate and that the actual charges for the health care service are dependent on the circumstances at the time the service is rendered; and
The following statement or a statement containing substantially similar information:
If you are covered by health insurance, you are strongly encouraged to consult with your health insurer to determine accurate information about your financial responsibility for a particular health care service provided at this health care facility. If you are not covered by health insurance, you are strongly encouraged to contact (insert office name and telephone number) to discuss payment options prior to receiving a health care service from this health care facility since posted health care prices may not reflect the actual amount of your financial responsibility.
(3) A health care facility may disclose the basis for its health care prices and may take into consideration all payer sources when determining a health care price.
Source: L. 2017: Entire article added, (SB 17-065), ch. 113, p. 406, § 1, effective January 1, 2018.