Massachusetts Fee Disclosure for Radiology and Imaging Services Initiative (2018)

Massachusetts Fee Disclosure for Radiology and Imaging Services Initiative
Election date November 6, 2018
Topic Healthcare
Status Not on the ballot
Type State statute	Origin Citizens
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The Massachusetts Fee Disclosure for Radiology and Imaging Services Initiative was not on the ballot in Massachusetts as an indirect initiated state statute on November 6, 2018.

The measure was designed to require providers of radiology and imaging service procedures to disclose the fees charged to patients for using equipment, rooms, supplies, and personnel to operate equipment. Providers would have been required to give this information to patients before a procedure and display this information at their physical sites and post a link on their websites titled Fees for Radiology and other Imaging Procedures. The Massachusetts attorney general would have been responsible for enforcing the initiative.

Knute S. Alfredson, the lead sponsor of the measure, filed two versions of the initiative. The difference between the two versions was related to how long a provider would have had to respond to a non-compliance inquiry letter from the attorney general. Initiative 17-02 would have required a response in 30 days. Initiative 17-04 would have required a response within 60 days.

Text of measure

Petition summary

The attorney general approved two versions of this initiative for circulation:

Initiative 17-02

This proposed law would require medical providers to affirmatively inform patients of the costs of all radiology and imaging procedures priced over $100, including fees for use of equipment, room, supplies, personnel, and other ancillary costs. This proposed law would take the place of the current law requiring medical providers to disclose the costs of all medical admissions, procedures, or services within two working days of a patient’s request. The proposed law would require medical and dental practices and facilities to disclose the cost of radiology and imaging procedures in three ways. First, providers that maintain websites would be required to include a link entitled “Fees for Radiology and other Imaging Procedures.” There, the provider would be required to identify the procedures and, for each one, supply the billing code submitted to Medicare and the undiscounted fee for the procedure. Second, the provider would be required to conspicuously display this information where the procedure is performed. Finally, prior to the procedure being performed, the provider would be required to give the patient a written statement including the name of the procedure, the Medicare billing code, the undiscounted fee, and the amount of any discount for uninsured individuals. The proposed law would also require providers of radiology and imaging services to, upon request, give patients covered by health plans the Medicare billing code of the radiology service and a toll-free number where the patient could get information about out-of-pocket costs. Failure to comply with the proposed law’s disclosure requirement would constitute a violation of Chapter 93A of the General Laws and the Attorney General would be responsible for enforcing the proposed law’s requirements. The Attorney General could request assistance from state agencies to conduct surveillance of medical provider websites and could perform on-site inspections and respond to consumer complaints. If the Attorney General had reason to suspect non-compliance with the requirements of the proposed law, she could send an inquiry letter, requiring the provider to respond within 30 days and detail any planned remedial action. If the Attorney General concluded that non-compliance continued 30 days after the inquiry letter, she could send a warming letter advising the provider of possible license suspension or revocation in the event of continued non-compliance. If non-compliance continued 45 days after the warning letter, the provider could be called to appear before the Attorney General or an agency designated by her and be suspended from practice. If non-compliance continued beyond 90 days, the relevant licensing board could revoke the provider’s license. This proposed law would take effect on January 1, 2019.

Initiative 17-04

This proposed law would require medical providers to affirmatively inform patients of the costs of all radiology and imaging procedures priced over $100, including fees for use of equipment, room, supplies, personnel, and other ancillary costs. This proposed law would take the place of the current law requiring medical providers to disclose the costs of all medical admissions, procedures, or services within two working days of a patient’s request. The proposed law would require medical and dental practices and facilities to disclose the cost of radiology and imaging procedures in three ways. First, providers that maintain websites would be required to include a link entitled “Fees for Radiology and other Imaging Procedures.” There, the provider would be required to identify the procedures and, for each one, supply the billing code submitted to Medicare and the undiscounted fee for the procedure. Second, the provider would be required to conspicuously display this information where the procedure is performed. Finally, prior to the procedure being performed, the provider would be required to give the patient a written statement including the name of the procedure, the Medicare billing code, the undiscounted fee, and the amount of any discount for uninsured individuals. The proposed law would also require providers of radiology and imaging services to, upon request, give patients covered by health plans the Medicare billing code of the radiology service and a toll-free number where the patient could get information about out-of-pocket costs. Failure to comply with the proposed law’s disclosure requirements would constitute a violation of Chapter 93A of the General Laws and the Attorney General would be responsible for enforcing the proposed law’s requirements. The Attorney General could request assistance from state agencies to conduct surveillance of medical provider websites and could perform on-site inspections and respond to patient complaints. If the Attorney General had reason to suspect non-compliance with the requirements of the proposed law, she could send an inquiry letter, requiring the provider to respond within 60 days and detail any planned remedial action. If the Attorney General concluded that non-compliance continued 60 days after the inquiry letter, she could send a letter notifying the provider of the continued non-compliance and giving the provider 30 days to comply. If non-compliance continued 30 days after this letter, the Attorney General could send a warning letter advising the provider of possible license suspension or revocation in the event of continued non-compliance. Notice of this warning letter would be posted on the Attorney General’s website and the website of the provider’s licensing board. If non-compliance continued 45 days after the warning letter, the provider could be called to appear before the Attorney General or an agency designated by her and be suspended from practice. If non-compliance continued beyond 90 days, the relevant licensing board could revoke the provider’s license. This proposed law would take effect on January 1, 2019.

Full text

The full text of the measure is available for Initiative 17-02 and Initiative 17-04.

Path to the ballot

See also: Laws governing the initiative process in Massachusetts

In Massachusetts, the number of signatures required to place an indirect initiated state statute on the ballot is equal to 3.5 percent of votes cast for governor in the most recent gubernatorial election. The first 3 percent is collected in order to refer the indirect initiative to the Massachusetts General Court. If members of the General Court pass and the governor signs the initiative, then the initiative becomes law. If the legislature declines to act on an initiative or the governor vetoes it, sponsors of the initiative need to collect additional signatures equal to 0.5 percent of the votes cast for governor.

To make the 2018 ballot, sponsors of this initiative needed to collect the first round of 64,750 signatures between September 20, 2017, and November 22, 2017. Petitioners did not submit signatures for the initiative to the office of the secretary of the commonwealth by the deadline on December 6, 2017. If signatures had been submitted, and the General Court had rejected or not acted on the initiative by May 2, 2018, then an additional 10,792 signatures would have been required by July 4, 2018.

Petitioners filed two versions of the initiative. On September 6, 2017, Attorney General Maura Healey (D) approved both versions of the initiative for signature gathering. Signatures were not submitted for either version.

See also

2018 measures

• 2018 ballot measures
• Healthcare on the ballot

Massachusetts

• Massachusetts ballot measures
• Massachusetts ballot measure laws

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