By Tina Reed
October 6th, 2022
Almost two years after a Trump-era price transparency rule took effect, many hospitals are flouting a requirement that they post the prices for common goods and services online — with little risk of facing penalties, Axios’ Victoria Knight writes.
Driving the news: A new report shared with Axios shows continued industry resistance to a rule some believed would lead to more price competition or further regulation.
The report, published today by the consumer advocacy group, PatientRightsAdvocates.org, is one of the first to compare hospital disclosures and a separate set of public pricing reports that insurers and group health plans had to start posting on July 1.
“Some of the prices that are found in insurance company price files appear with an ‘N/A’ or are blank in the corresponding hospital price lists,” the group wrote. “This concrete evidence from the insurance files demonstrates that real prices exist and hospitals are flouting the hospital price transparency rule.”
Details: The hospital transparency regulation went into effect in January 2021. Since then, multiple reports have shown high rates of non-compliance, such as a June study that found only 6% of facilities covered by the rule were totally compliant in the first six months it went into effect.
Only two hospitals in Georgia have been fined by the Centers for Medicare and Medicaid Services since the regulation went into effect. CQ Roll Call reported in June that since January 2021 CMS had issued about 352 warning letters to hospitals for non-compliance.
More insurer transparency requirements are slated to go into effect in the next two years. In 2023, insurers must share the costs of the 500 most “shoppable” health care services in a cost estimator tool, and by 2024, publicize the cost of every item and service they provide.
The other side: “While hospitals press forward to help patients understand their anticipated costs for care, some outside groups are taking this opportunity to mischaracterize what is happening in the field with respect to the Hospital Price Transparency Rule,” said American Hospital Association spokesperson Sean Barry in a statement to Axios.