The Trump administration moved Friday to require hospitals to publicly post prices for medical care, including both standard charges and the costs for care and services negotiated by insurers.
“Today’s transparency announcement may be a more significant change to American healthcare markets than any other single thing we’ve done, by shining light on the costs of our shadowy system and finally putting the American patient in control,” Health and Human Services Secretary Alex Azar said Friday.
One part of the administration’s plan is a proposed rule requiring that insurers provide patients a view of the costs they are responsible for paying, either online or on paper. Plans would also have to make public the costs of services after hospitals have negotiated the prices with insurers, as well as provide estimates for out-of-network providers.
The second part of the rule, finalized Friday, requires hospitals to publicly post standard charges for medical care, including procedures and prescription drugs administered in the hospital.
Seema Verma, Centers for Medicare and Medicaid Services administrator, said the rule will allow patients to compare prices of certain services at various hospitals, including X-rays, lab tests, and cesarean sections, thus increasing competition.
The finalized rule is set to take effect Jan. 1, 2021.
Hospitals and insurers generally do not disclose prices of procedures. They are likely to fight the new rules in court.
“We may face litigation but we feel we are on a very sound legal footing with what we’re asking,” Azar said in a Friday press call. “I would certainly hate to see hospitals take a play out of pharma’s playbook and oppose transparent pricing information.”
CMS will have the power to monitor, audit, make corrective action plans for health systems that refuse to comply and will even charge hospitals $300 with each day that they do not comply with the rule.
President Trump will expound on the proposed and finalized rules at 2 p.m. Friday.