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Most Hospitals Aren’t Complying With Federal Price Transparency Rules

The latest report from PatientRightsAdvocate.org (PRA) underscores the ongoing challenges in achieving full compliance with the federal Hospital Price Transparency Rule, which mandates that hospitals publicly disclose prices for their services. The findings reveal a concerning lack of adherence among hospitals nationwide, with only one-third (34.5%) of the 2,000 hospitals reviewed meeting the requirements. This figure remains virtually unchanged from the previous year's results, indicating a persistent pattern of noncompliance despite regulatory efforts. The report underscores the importance of hospital price transparency in empowering consumers to make informed choices about their healthcare and mitigating financial risks associated with medical services. Employers, in particular, are urged to recognize the role they play as stakeholders in the healthcare ecosystem and to leverage available pricing and claims data to optimize plan designs and steer employees towards cost-effective, high-quality care providers. Click here for article.

  1. Compliance Rates: The report indicates that a significant majority of hospitals, 65.5%, were not fully compliant with the Hospital Price Transparency Rule. This suggests a widespread issue within the healthcare industry regarding transparency in pricing practices.

  2. Variability in Compliance: While some hospitals managed to fulfill the transparency requirements, others fell short, with 87 hospitals (4%) failing to post any usable standard chargers file, rendering them in total noncompliance. Additionally, 135 hospitals exhibited "backsliding," meaning they were compliant in the previous report but failed to meet the standards in the current assessment.

  3. Enforcement Challenges: Despite the evident lack of compliance, enforcement measures by the Centers for Medicare & Medicaid Services (CMS) appear to be inadequate. Only 14 hospitals received penalty notices, suggesting leniency in holding non-compliant institutions accountable.

  4. Impact on Consumers: The absence of comprehensive price transparency in healthcare poses significant challenges for consumers. Without access to upfront pricing information, individuals are left vulnerable to unexpected medical bills and may face financial strain due to healthcare expenses. This undermines the fundamental principle of informed decision-making and can contribute to the perpetuation of medical debt among Americans.


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