The Patients Right to Save Act introduces significant measures aimed at enhancing transparency and affordability in healthcare services in Iowa. The bill mandates that healthcare providers disclose the discounted cash price for specific services when paid in cash, ensuring this information is accessible to both insured and uninsured individuals. Providers are required to review these prices annually and inform patients of their right to pay using the discounted cash price prior to scheduled services. Additionally, the bill prohibits contracts that restrict providers from offering discounted cash prices below contracted rates, thereby promoting competitive pricing.

Moreover, the legislation establishes a framework for health benefit plans to disclose average allowed amounts for covered services, ensuring that individuals who choose discounted cash prices below these averages receive credit toward their cost-sharing obligations. It also introduces a savings incentive program that rewards individuals for utilizing discounted cash prices, with shared savings between the individual and their health benefit plan. The bill requires that out-of-pocket pricing for drugs be accessible to pharmacists and mandates that providers furnish itemized lists of services for cash payments. Furthermore, it outlines procedures for appealing denied proof of payment and tasks the Department of Administrative Services with analyzing the cost-effectiveness of these programs for state employees, with a report due by September 1, 2026. If found cost-effective, the programs will be implemented for the 2027 open enrollment period.

Statutes affected:
Introduced: 507B.4