Although no one has ever been charged with the offense, maximum fines for health care providers who seek up-front payment, rather than awaiting insurance payment, will increase from $5,000 to $13,000 if a bill working its way through the Senate becomes law.
Carl Richardson, legal counsel for the Health Department, testified against the bill, saying the current fines are sufficient because there have been extremely few complaints about providers demanding payment beforehand from insured customers, and the fine "has never been implemented."
Sen. Alvin Williams, the bill’s sponsor, disputed Richardson’s contention, saying he had received numerous complaints from constituents, especially for dentistry. Richardson suggested some may be getting confused about their bills and about their deductibles and co-payments.
Williams said that may happen, but he believes there are dentists charging up-front.
"So this is happening a lot, but our public is not aware of it," Williams said. "I am not saying all of the doctors; most of our doctors have the utmost integrity, but some are [charging beforehand]."
Sen. Patrick Sprauve, the committee chairman, asked Richardson if he felt the bill even needed amendment.
"It seems you don’t believe there is anything wrong with the law," Sprauve said.
"That is correct," Richardson said. "I think $5,000 is a sufficient deterrent, and I believe that may be the very reason we haven’t had any complaints as it pertains to accepting insurance plans."
Voting yea were Sprauve, Williams, Sens. Usie Richards and Sammuel Sanes. Sen. Craig Barshinger voted no. O’Reilly and Sen. Shawn-Michael Malone were absent at the time of the vote.
The committee also approved a bill appropriating $3 million from the interest on debt service reserves for the construction of a mental health facility on St. Croix.
Human Services Commissioner Chris Finch, Gov. Juan F. Luis Hospital Chief Executive Officer Jeff Nelson and others testified that while the territory needs such a facility, $3 million is not enough and it may be imprudent to build a facility without a more concrete plan, and a sustainable funding source for operating and maintaining it.
Nelson commended "the spirit of the bill" but said, “We must consider other relevant issues, for example … the funding for the institution’s upkeep and maintenance, recruitment and training."
"Funding is limited, and the continuation of all types of programs, including mental health services, are threatened," Finch said. "Despite my strong desire … at the present time we cannot support new construction unless there is sufficient funding for operating and maintenance costs."
The $3 million would only buy a rather small 7,000- to 9,000-square-foot facility, too, he said. However, Finch said the best solution may be to renovate and expand the Eldra Schulterbrandt long-term care facility on St. Thomas.
If patients that are currently being sent stateside at great expense are then moved back form stateside, "it may be possible for this to be funding-neutral, if the costs of the facility are comparable to the costs of sending them elsewhere," he said.
Voting to send the bill out of committee were: Sprauve, Sanes and Williams. Richards voted no, while Barshinger abstained. Malone and O’Reilly were absent.
The committee also approved a bill to promote the use of electronic medical records by establishing that electronic records and electronic signatures meet all legal standards for medical documentation, clarifying individual rights with respect to disclosure of private information and defining what qualifies as a permanent electronic record.
The bill, entitled the Electronic Medical Records Act, passed unanimously.