Trump Administration Would Require Hospitals To Post Closely Guarded Prices Stemming From Secret Negotiations With Insurers
The rule is part of a broader push by the administration to increase transparency in health care, but economists argue that posting negotiated prices is meaningless because it does not tell patients their actual out-of-pocket costs. The rule is also certain to provoke swift legal challenges from the industry.
The New York Times:
Hospitals Would Have To Reveal Discounted Prices They Give Insurers, Under Trump Rule
The Trump administration on Monday said it would begin forcing hospitals to publicly disclose the discounted prices they negotiate with insurance companies, a requirement intended to help patients shop for better deals on a range of medical services, from hip replacements to CT scans. The plan, issued as a proposed federal rule, would take effect in January, but would likely be challenged in court by an industry that has long held such rates secret. (Abelson and Goodnough, 7/29)
The Washington Post:
Trump Administration Proposes First Rule On Health-Care Cost Transparency
Health insurers and providers have fiercely opposed having to publicly reveal their negotiated prices, which they say would stifle competition. Yet the Trump administration has argued that forcing hospitals to post their prices will allow consumers to make more informed choices about where to get care and in turn help lower their health-care costs. Trump has said he is eager to make health care a central plank of his 2020 reelection bid, as voters consistently cite high costs as one of their top concerns. Trump’s June executive order laid out priorities for the Department of Health and Human Services and other agencies in crafting rules to address secrecy in health-care prices. (Abutaleb, 7/29)
The Hill:
Trump Administration Would Force Hospitals To Disclose Secret Prices
Hospitals that fail to disclose that information could be fined, but the fines would be limited to only $300 a day. Hospitals are already required to publicly post their list prices for services, but in a call with reporters, Centers for Medicare and Medicaid Services Administrator Seema Verma said the proposal would expand that requirement to include gross charges before discounts as well as the insurer-specific negotiated charges for all items and services. (Weixel, 7/29)
CNN:
Hospitals Soon Could Have To Reveal Negotiated Rates With Insurers
Patients would be able to search by hospital and insurance plan, though the information would not have their personal deductible or copay details, so it would not tell them what they would have to pay out of pocket. "We are taking a big step today to ensure that we are empowering patients with the information they need to make informed health care decisions," said Seema Verma, administrator of the Centers for Medicare and Medicaid Services. (Luhby, 7/29)
CNBC:
Trump Proposes Hospitals Publish Prices Negotiated With Insurers
Hospitals and insurers are certain to fight the proposed rule. These companies have already criticized Trump’s executive order requiring hospitals and insurers to disclose negotiated rates for services, saying transparency could actually increase prices. The effort announced Monday would codify Trump’s order. “Publicly disclosing competitively negotiated, proprietary rates will push prices and premiums higher — not lower — for consumers, patients, and taxpayers,” Matt Eyles, president and CEO of America’s Health Insurance Plans, said in a statement. (LaVito, 7/29)
The Wall Street Journal:
Hospitals May Be Forced To Disclose Discount Rates Negotiated With Insurers
Industry groups have argued the requirement goes beyond the executive branch’s statutory authority and could backfire by causing prices to rise if hospitals see their competitors are getting higher insurer payments. The White House has lost in court before: A rule requiring drug makers to post list prices in television ads was blocked in June by a federal judge who said the administration overstepped its regulatory authority. Some Republicans praised the administration’s focus. Sen. Lamar Alexander (R., Tenn.) said the proposal complements provisions in legislation he sponsored with Sen. Patty Murray (D., Wash.) to lower health costs. “We will carefully review how the proposed rule and our legislation interact,” he said. (Armour, 7/29)
Modern Healthcare:
Hospitals May Be Required To Publish Rates Negotiated With Insurers
The CMS would require gross charges and payer-negotiated prices to be posted online in a machine-readable format so that developers could incorporate them in consumer price transparency tools and electronic health records. Publishing prices in a standardized way will allow patients to do an "apples-to-apples comparison" on hospital prices, Verma said.
However, the proposal stops short of requiring hospitals to post patient-specific price information that would show patients where they are in meeting their deductibles, for example. (Livingston, Kacik and Luthi, 7/29)
CQ:
Administration Pushes Hospitals To Disclose Negotiated Prices
Backlash from the hospital industry was swift. “While we support transparency, today’s proposal misses the mark, exceeds the Administration’s legal authority and should be abandoned,” American Hospital Association President and CEO Rick Pollack said in a statement. America’s Health Insurance Plans also voiced support for the broad concept but opposition to the details, pointing instead to pricing tools that insurers offer their members. (Clason, 7/29)
