RI Insurers Must Disclose Prices to Doctors

May 23, 2013

For the first time, Rhode Island’s insurance commissioner has directed health insurers to disclose what they pay for health care services. But that information won’t necessarily be directly available to patients.

Insurance commissioner Chris Koller issued a bulletin requiring health insurers, or carriers, to tell health care providers on request what they pay other providers for similar services. The idea is to give doctors the information they need to help patients make the most cost-effective decisions about their health care. Koller says health care providers are being asked more frequently to help control costs.

“And yet when they ask carriers for information they’re told well, we cannot disclose that because we’ve signed these non-disclose contracts with other providers," said Koller, "so we can’t give information on the prices we pay to them to you. And the providers actually came to us for help.”

So Koller’s office issued the bulletin requiring that disclosure, on request, by this summer. By next spring, he’s asked insurers to come up with a plan to disclose more information directly to consumers, although it’s up to insurers to decide which information they’ll release. The ruling isn’t law, but Koller’s office has some regulatory tools to encourage compliance.