Montana officials continue to question the price of health care

csimt In The News

By: Katheryn Houghton 

As the cost of health care climbs, Montana’s insurance watchdog is weighing whether hospitals’ defense that their prices are designed to cover the cost of business rings true.

Global think tank Rand Corporation released a study this year that showed Montana hospitals charged private insurance two-to-four times beyond what Medicare pays.

During the annual Montana Insurance Summit in Helena on Wednesday, Deputy State Auditor Kris Hansen said the office found in recent years that one Montana hospital’s average reimbursement was 611% beyond Medicare…

Roughly 200 people attended the summit by the office of the Commissioner of Securities. State officials talked major steps over the last year and what’s to come. That includes the effort to understand how health care prices take shape, a longstanding black box within the industry.

Hospital officials have said government payment like Medicare falls short so they look toward private insurers to make up the difference.

Marilyn Bartlett, special projects coordinator for the Commissioner of Securities and Insurance, said the office is trying to figure out whether that’s true…

During the summit, Insurance Commissioner Matt Rosendale outlined some of the office’s successes and defeats around the cost of care.

Rosendale, also a GOP candidate for Montana’s U.S. House Seat, touted a reinsurance program lawmakers approved this year. The aim is to create a new pool of money that will help insurers cover high-cost insurance claims.

As part of the program’s ripple, the three Montana companies that offer health insurance policies on the individual marketplace are offering reduced rates in 2020.

Rosendale said the office will continue to work on proposals that didn’t become law.

That includes Senate Bill 71, which Sen. Albert Olszewski, R-Kalispell, sponsored at the request of Rosendale’s office. The bill would have increased oversight on pharmacy benefit managers — companies that help set health care prices.

The bill passed but was vetoed by Montana’s Democratic Gov. Steve Bullock.

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