Price Transparency and Hospitals

New court ruling to benefit consumers.

Earlier this year, we discussed “The Debate Over Transparency.” That topic involves providing more information to the public about all aspects of healthcare operations. One key part of this relates to price transparency and hospitals. Up until now, many factors related to the prices charged have been obscured.

New Court Ruling on Price Transparency and Hospitals

While yet a done deal, a major court decision will promote more price transparency in hospitals. Then, why is this not a done deal? Experts expect appeals of the verdict. For insights, we turn to two Fierce Healthcare articles by Robert King.

The Ruling

First, we look at the ruling:

[Last week], “a federal judge ruled against a lawsuit brought by hospital groups that challenges the Trump administration’s rule to require hospitals post charges they negotiate with payers. The ruling issued by the U.S. District Court for the District of Columbia dealt a major blow to hospitals — as well as insurers — who claimed the Centers for Medicare & Medicaid Services’ rule that goes into effect in January is onerous.”

“Hospital groups sued CMS late last year charging the agency did not have the statutory authority to mandate the rule. It requires hospitals post payer-negotiated charges in order to give consumers more transparency. The judge also shot down hospitals’ arguments about the burden of the rule. The lawsuit said that the rule could require hospitals to publish a long list of charges because a hospital often negotiates a different charge with a different payer for the same service or procedure.”

What Will Hospitals Do Now?

Second, what is next?

“A court ruling upholding a controversial price transparency rule puts hospitals in a tight spot. How to comply with the regulation in the middle of a pandemic. Even though the groups issued plans to appeal, hospitals must weigh whether to start preparing for the rule. It goes into effect on Jan. 1, 2021.”

“’They need to be thinking about the practical implications of their compliance. They must make public information about pricing that has not up until now been public.’ According to Michael Abrams managing partner of the consulting firm Numerof Associates.”

“But hospitals have been hit hard by the COVID-19 pandemic. With some systems furloughing or laying off people. As well as clinical staff stretched to the limit to deal with cases.”

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Price Transparency and Hospitals
A federal judge ruled against hospital groups seeking to get rid of a CMS price transparency rule that requires facilities to post payer-negotiated rates. (Image: Pixabay)