Senate panel hears Sen. Clark's itemized healthcare bill bill

Clark (D-Portsmouth) has introduced bill requiring itemized bills for every visit to a healthcare provider

(Concord, NH) Today Senator Martha Fuller Clark introduced legislation before the Senate health, Education and Human Services Committee that would require all medical providers to give every patient an itemized bill for their services. Current New Hampshire law requires providers to make itemized bills available but few patients know to ask for such bills and if provided, they may often lack adequate description of services.

Speaking prior to the hearing, Fuller Clark pointed to a hospital visit by her husband Dr. Geoffrey Clark for a minor procedure.

"My husband knew enough to ask for an itemized bill. When he got home and looked at it, he noticed a battery of errors, from duplication of charges to more complicated mistakes. The errors were corrected, but we had to call the hospital and make sure our insurance wouldn’t be charged," Clark said.

The Clarks' experience has been confirmed by studies from a variety of sources including a 2012 Thomson Reuters study entitled "Save $36 Billion in U.S. Healthcare Spending Through Price Transparency," which Fuller Clark cited during her testimony before the committee.  

"Our history of deeply insulating consumers from the costs of their healthcare choices and pervasive systems that obscure visibility into the cost of services bear at least some of the blame for year-after-year double-digit growth percentages for healthcare costs," the study observed. "More conscious healthcare choices by consumers will create engaged, informed, educated consumers – and by our estimate, save $36 billion (3.5%) from annual healthcare expenditures." [1]

New Hampshire is already leading in the field of medical cost transparency with the NH Health Cost webpage ( This page, developed by the NH Dept. of Insurance and the Commissioner's Advisory Committee on Health Insurance, has been used as a model by states throughout the country. Clark’s legislation will require that names of providers are also included in addition to the names of hospitals currently covered and strengthens her previous legislation regarding how providers arrive at an average price for specific procedures and services for uninsured patients. Sen. Clark, who was deeply involved in the creation of NH Health Cost, views this latest legislation as both a tool for patients to better understand and manage their healthcare costs and protect a consumers’ right-to-know.


While representatives of hospitals and physicians expressed worry about potential price increases, Tyler Brannen from the New Hampshire Department of Insurance suggested that economies of scale could greatly limit the financial impact on healthcare providers. Currently only about 1% of hospital patients ask for itemized bills for the services they’ve been provided, according to the New Hampshire Hospital Association’s Paula Minnehan.


Senator Andy Sanborn (R-Bedford) expressed hope that this legislation could help contain future costs thanks to price transparency.


“Don’t you think we need to begin a conversation about why we have the second-highest healthcare costs in the country?” Sanborn asked hospital representative Paula Minnehan. “It’s time belly up and start providing (cost transparency).”


Also testifying in favor of the legislation was founding executive director of the New Hampshire Innovation Commercialization Center and serial entrepreneur Mark Galvin. Galvin, who using health savings accounts to limit the cost his health care, aggressively comparison shops for health procedures. He demonstrated an app that allows people to better shop for procedures to underscore the importance of transparency in the healthcare marketplace.