Forum gathers input on proposed Ketchikan health billing regs

A handful of Ketchikan residents provided input Wednesday on a proposed City of Ketchikan ordinance that would require health care providers to give cost estimates when patients ask for that information.

Some people were for the ordinance, others not so much.

The city’s ordinance already has passed one hurdle. The Ketchikan City Council approved the set of regulations in first reading. But, it has to come back for a second vote, which is set to happen on April 5^th.

That gives the city time to collect input from health care professionals and the general public. Both of those groups were represented during the public forum hosted by city officials.

George Shaffer has been a dentist in Ketchikan for about 40 years. He objected to the ordinance. He said he already provides cost estimates, and adds that the proposal is too broad based — the regulations won’t work for all providers.

“Some of the providers are large groups. Some are solo practitioners,” he said. “Some have straightforward treatment plans and fees. While some deal with much more complicated treatment plans with a wide range of treatment plans and fees.”

Shaffer said local dentists request a delay so they can work with the city on regulations that make more sense for all the different providers. He points out that the Alaska Legislature also is considering a health billing transparency law. If approved, it would supersede local regulations. Shaffer said that’s another reason the city should wait.

The state bill and the city’s ordinance are similar. Both would require providers to give an estimate of reasonably anticipated charges within 10 days if requested by a patient. That estimate would include billing codes and other fees. Failure to comply would result in a fine.

Ed Zastrow is in favor of some kind of required health billing transparency. He is president of Ketchikan’s AARP, and said health billing is a big concern for senior citizens.

“Because so many folks are on fixed incomes and then all of a sudden, the surprise comes where they had no idea whatsoever what the cost of whatever that treatment happened to be,” he said.

Chelsea Goucher is president of the Ketchikan Chamber of Commerce. She said the chamber is in favor of health billing rules, and encouraged the city to draft the ordinance. She said that was in response to the public’s growing frustration with the growing costs of health care.

She said neither the state bill nor the local ordinance would solve all the problems, but they are a first step.

“And I think also, it sets guidelines that both providers and consumers can work within to begin to understand each other and have a meaningful dialogue rather than going out on the street and badmouthing an organization or a business because a consumer didn’t feel they were provided with the information they were seeking,” she said.

Goucher said transparent costs will eventually help local businesses and the market in general.

City Council Member Judy Zenge has been pushing for the council to take up this issue. She told the audience that some changes could be made to the ordinance, but she hears a lot of complaints from the public, mostly about bills from PeaceHealth Ketchikan Medical Center.  

“I think it’s fair to ask that there be some type of framework where people don’t get frustrated,” she said. “They’re already having to go in for a procedure and now they gotta fight through the system to get a price? That doesn’t seem fair.”

Abby Bradberry is a PeaceHealth patient who said she tried to get an estimate from the hospital before an appointment. She said she fell and hurt her knee, so had to go see an orthopedic surgeon. Bradberry got the code for a visit with the surgeon, and then called the help line for an estimate.

“And they told me that my estimate was $68 to see an orthopedic surgeon,” she said, generating some laughter from the audience. “I said that’s really hard to believe because I can’t go see a regular provider for a physical for under $250.”

But, she said, after follow-up phone calls, that code remained the only code they had for her. Bradberry said she ended up with a bill significantly larger than $68, even after factoring in her insurance.

Kristen Zwicker said she had a similar surprisingly large bill from PeaceHealth. But, she also works in the health care field as the office manager at Ketchikan Eye Care Center.

“A problem that our office is seeing is, our patients have no idea what their insurance coverage is,” she said.

Zwicker said patients, too, have a responsibility to provide proper information to health care businesses.

The city council can make changes to the local ordinance when it comes back for its second reading in early April. The state measure, House Bill 123, was introduced in 2017 and hasn’t made it to the floor for a vote yet. According to the Legislature’s website, its last real action was a referral to the Health and Social Services Committee.  

The City of Ketchikan is accepting written comments on its health billing ordinance through Friday, March 23^rd. Comments can be sent to the City Clerk’s Office, 334 Front Street; or emailed to City Clerk Katy Suiter at katys@ktn-ak.us