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Originally published: 2013-05-13 11:30:09
Last modified: 2013-05-13 11:31:51

Bill aims for more transparency in NC health costs

by Anna Oakes

The N.C. Senate on Thursday unanimously passed a bill that aims for greater transparency in hospital and other health care costs.

Senate Bill 473, sponsored by Republican Sens. Bob Rucho and Harry Brown, would require hospitals and surgical facilities to disclose the costs of the 100 most common inpatient services and 20 most common surgical and imaging procedures, including what is charged to uninsured patients, Medicaid and Medicare recipients, State Health Plan enrollees and those insured by the state's five largest insurance companies.

The legislation also extends the time period for patients to request itemized medical bills and requires providers to furnish invoices written in clear, easy-to-understand language. Providers must give a 30-day notice before an account is sent to collections, under the bill, and limitations are placed on a hospital's ability to place liens on homes for outstanding debts.

The bill also requires hospitals to provide public access to their charity care policies and to annually disclose the amounts they spend on charity care. And it makes it unlawful for health care providers to charge or accept payment for any procedure that was not performed.

A statement published by the N.C. Republican Senate Caucus Thursday credited a 2012 series by the News & Observer and Charlotte Observer for highlighting ongoing problems with transparency and rising health care costs.

"Unlike almost any good or service available to purchase, the true cost of health care is often a mystery," Rucho and Brown said in the statement. "As consumers, we can comparison-shop when we buy a car, a computer or airline ticket. We should be able to do the same with health care."

The N.C. Hospital Association provides an online database publishing the costs of the top 35 inpatient procedures for the state's hospitals, including Watauga Medical Center. However, the database lists only what is said to be an "average charge" per procedure and does not delineate charges according to various forms of payment.

Voter ID

House Bill 589 -- the Voter ID bill -- passed the N.C. House of Representatives by a vote of 81-36 April 24, largely along party lines. The bill is now in a Senate rules committee.

The bill requires citizens to furnish a government-issued photo identification that is not more than 10 years beyond the expiration date in order to vote. Those without an ID or who election officials determine do not resemble the photo may vote on a provisional ballot, which will be counted if a photo ID is provided and if voter eligibility can be verified, according to the bill.

The bill provides for the issuance of a photo ID and birth certificate at no charge.

The measure has faced opposition from the North Carolina NAACP and other groups, who say the bill will make voting more difficult for minorities, seniors, women and the poor.

Regulatory Reform

The Regulatory Reform Act of 2013 continues to advance through the General Assembly, with 36-11 passage by the N.C. Senate May 2. The House Committee on Regulatory Reform is currently considering the bill.

The bill would modify state statutes to prohibit cities and counties from enacting ordinances that are more stringent than existing state or federal regulations for the field being regulated, unless the ordinance is required by a serious threat to public health and safety or an act of the state, federal government or courts.

The legislation also would create a fast-track approval process for stormwater management system permits and erosion and sedimentation control plans and would allow third parties to contest decisions on air and water quality permits.

Renewable Energy Mandates

House Bill 298 -- which would roll back the renewable energy quotas required of North Carolina utility companies -- appears to have stalled in the House, but a similar bill is moving through the Senate.

The bill advanced from the Senate Finance Committee May 1 when, according to media reports, committee co-chairman Bill Rabon determined the bill had passed on a voice vote. But interviews of committee members by Raleigh's WRAL determined the bill would have failed in committee if a formal vote count had been called.


House Bill 937, approved by the House and now in the Senate, would allow concealed firearms to be carried in bars and events charging admission unless property owners post notices prohibiting them. It would also permit concealed firearms in public parks and greenways and in vehicles on state government parking lots and public and private university campuses.

Interbasin Transfers

Senate Bill 341 would permit the transfer of up to 5 million gallons per day from one river basin to another. Current law permits the transfer of up to 2 million gallons per day between river basins.

Watauga County falls within four river basins: Most of the county lies in the New River and Watauga River basins, but small portions are also located in the Yadkin-Pee Dee and Catawba River basins.

The bill passed the Senate May 1 and has been referred to the House Committee on Environment.