How Louisiana is pulling back the curtain on medical billing Image By Michael Echols In Louisiana, we’ve been fighting a quiet but costly battle — one that affects every driver, business owner, worker and taxpayer. It’s not about political ideology or partisan gridlock. It’s about something far more basic: the price of care and how it’s being manipulated behind closed doors. Across the country, states are grappling with the high cost of auto insurance and workers’ compensation. But here’s what we’ve discovered in Louisiana: One of the biggest drivers of these costs is the use of inflated “billed charges” — not the actual cost of delivering care. These are the hospital or provider’s sticker prices, which often have little to do with what anyone actually pays in a normal insurance or Medicare transaction. In too many cases, these billed charges are being used in lawsuits and reimbursement systems to inflate settlements, increase payouts and drive up premiums for everyone else. Louisiana families are paying the price in the form of some of the highest auto insurance and workers’ comp rates in the country. And we’re not alone. These same billing practices are quietly distorting costs in states across America. It’s a national problem hiding in plain sight. Pricing and paying for healthcare In Louisiana, we’re doing something about it. I’ve authored and co-authored legislation aimed at bringing fairness, transparency and accountability to how we price and pay for healthcare — especially when it’s tied to injury claims. Our approach is straightforward: Tie medical payments to actual market rates, not arbitrary “billed” figures. We’ve proposed reforms to update our state’s workers’ comp medical fee schedule to reflect what providers actually get paid, not what they choose to bill. Require price transparency in court. In auto injury cases, we’re working to ensure that only the true cost of medical care — not the inflated billed amount — can be used when determining damages. This reduces excessive payouts and prevents legal gamesmanship that drives up premiums. Hold intermediaries accountable. Whether it’s a hospital operator inflating lease rates or a Pharmacy Benefit Manager (PBM) hiding rebates and fees, we’re empowering our Attorney General to investigate profiteering and recover damages on behalf of taxpayers. Create data-driven oversight bodies. We’ve proposed bipartisan panels of healthcare experts, employers and physicians to help modernize reimbursement systems and stop runaway costs before they start. This isn’t about punishing healthcare providers — many of whom are simply operating within the flawed systems they’ve been handed. It’s about creating clear rules, honest pricing and predictable costs that allow our insurance markets to function fairly. Transparency and accountability key to change Other states considering similar reforms should take note: The key to lowering premiums, reducing fraud and restoring trust in the system starts with demanding pricing transparency. If someone breaks his or her arm in a car wreck, that person shouldn’t receive a $20,000 bill for care that would cost $2,500 under a normal plan. That gap isn’t just unsustainable — it’s unethical. Transparency works. When you tie payments to real costs, you remove the incentive for billing manipulation. When you force disclosure in courtrooms, you make the system more equitable for insurers, plaintiffs and policyholders alike. And when you shine a light on hidden fees and rebates, you give lawmakers and regulators the tools they need to protect the public. Other states — red or blue, large or small — can adopt these principles without overhauling their entire systems. These are targeted, common-sense reforms that restore integrity to the way we pay for care. Smart legislation In Louisiana, we’ve started the process. Some reforms have passed; others are still being debated. But we’re not done yet. At our Capitol, we’re committed to pushing forward with smart legislation that puts working families and small businesses first — not billing schemes and legal loopholes. To policy makers across the country: If you’re serious about lowering costs and protecting your constituents, take a hard look at how healthcare is being billed and priced in your state. The answer may not lie in more spending or stricter mandates, but in something as simple and powerful as transparency. It’s time to pull back the curtain. Michael Echols is a Louisiana state representative, healthcare reform advocate and small business owner working to modernize insurance, workers’ compensation and medical pricing policies. *The opinions expressed in this column are those of the author and do not necessarily reflect the views of HealthPlatform.News.
