Lawmakers urge HHS to conduct ‘vigorous oversight’ of hospital price posts after reports of noncompliance

Dive Brief:

  • A bipartisan group of lawmakers raised concerns about the lack of compliance among hospitals to post prices for services online. A new rule requiring them to do so went into effect Jan. 1 but compliance is spotty.  
  • The group called on HHS to step up oversight of the price transparency rule in a letter to HHS Secretary Xavier Becerra. The letter urged the department to conduct regular audits of hospitals and to revisit available enforcement tools, including the amount of the civil penalty for noncompliance, which is just $300 per day.
  • The group also requested a briefing from HHS to go over the implementation of the rule and the agency’s auditing of hospitals so far.  

Dive Insight:

The new price transparency rule was supposed to allow the public, for the first time, the ability to see the prices for a slew of hospital services. However, many hospitals are failing to comply with that rule, attracting the attention of lawmakers on the House Committee on Energy and Commerce. 

“We are concerned about troubling reports of some hospitals either acting slowly to comply with the requirements of the final rule, or not taking any action to date to comply,” the group said in the letter dated Tuesday.

A recent study found that a majority of the nation’s largest hospitals are unambiguously noncompliant” with the new rule. And a report from the Wall Street Journal discovered that hospitals were making it difficult to find prices by hiding them from search results. Researchers closely following the implementation of the rule have previously said noncompliance is very common

Earlier this year, CMS said it was conducting an audit of a small sample of hospitals and investigating complaints of noncompliance. The agency did not share any findings from those audits or complaints when Healthcare Dive followed up about whether any hospitals had faced a penalty as a result. 

Despite fierce pushback from the hospital lobby, the rule went into effect this year. The American Hospital Association went to court seeking to block the rule. It was ultimately unsuccessful in its bid, and attempted a last ditch effort to halt implementation in the waning days before the rule took hold. 

Still, the hospital data that have been shared largely affirms what researchers expected: wild swings in prices even for the same procedure within the same hospital.

An analysis by Healthcare Dive found the price of a knee replacement can range from $22,865 to as much as $101,571 at a Sutter Health hospital in San Francisco. The data reveal the price that’s paid all depends on the patient’s insurer.