A bill that would allow North Carolina State Health Plan administrators to see the prices of surgeries and other medical care advanced in the N.C. House on Tuesday. H.B. 169 allows the Health Plan access to its claims payment data and negotiated rates.
The State Health Plan provides insurance coverage for more than 750,000 state employees including teachers, law enforcement employees, state retirees, and their dependents. It costs N.C. taxpayers approximately two billion dollars annually.
The bill was filed in response to N.C. Treasurer Dale Folwell’s call for more transparency in health care pricing, but some members were concerned about how the state would use the information.
“The ultimate goal is to figure out what we are paying for health care on behalf of those who teach, protect, and serve our community, like yourselves,” Folwell told members of the N.C. House Pensions and Retirement Committee.
“At one hospital a C-section could cost $6,000 or $60,000,” he said. “It’s based literally on what kind of insurance you have.”
Members in more rural areas, were concerned that the N.C. Health Plan administrators would use the pricing data to set limits on how much the plan would pay for care.
“For me, being from a rural area out west, we may only have one MRI machine,” said Rep. Jeffrey Elmore, R-Wilkes. “If we move to a model that is flat rate, the margins get leaner and the money they are losing is just too much and that MRI machine could be gone… I’m not against you getting the information, I just don’t understand how the information is going to be used.”
Folwell told members that reimbursement limits were not the intention of the bill, rather he wanted to ensure that state employees’ health insurance were being charged a fair rate. Rep. Pat Hurley, R-Randolph, called into the meeting while recovering from an illness.
“I feel that Treasurer Folwell doesn’t ask for anything he doesn’t feel that he needs and it’s just common sense,” Hurley said. “We need to know what health care costs.”
“We are looking at the rate that someone pays for an operation or medical treatment,” said Rep. Rosa Gill, D-Wake. “The cost in one location might be different than in another location, but if we change this, will you pay for the cost of the procedure?”
“One hundred percent,” Folwell responded.
Members approved the H.B. 169, sending it to the N.C. House Health Committee.