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Committee backs bill to cap state plan hospital facility payments at 200% of Medicare; hospitals oppose
Summary
House Bill 15-02 would cap state employee health plan hospital facility reimbursements at 200% of Medicare in-network (185% out-of-network) and passed the Insurance Committee 8-3 after lengthy testimony from state officials and hospital representatives.
House Bill 15-02, sponsored by Representative Maguire, would change reimbursement for hospital facility charges under the state employee health plan to a reference-based model pegged to Medicare rates: 200% of Medicare for in-network facility fees and 185% for out‑of‑network fees. The Insurance Committee voted 8-3 to pass the bill after extensive testimony and debate.
Representative Maguire said hospital price growth is a major driver of rising premiums and described a repricing exercise the state performed on 2023 claims that estimated roughly $88.5 million in annual savings if facility fees were paid at 200% of Medicare. The proposal targets hospital facility fees only and does not change physician professional fees, the sponsor said.
Gloria Sachdev, secretary of the…
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