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Hospitals Sue Trump to Block Transparency Rule

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Date10 Dec 2019
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Comment0
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Hospitals Sue Trump to Block Transparency Rule

Hospital groups have filed a lawsuit against the Trump Administration in an effort to challenge a rule that would force them to disclose discounted prices they offer to individual insurers.

The rule will require that in 2021, hospitals will have to disclose the rates they privately make with individual insurers for all services. The lawsuit argues that this is, “Unlawful several times over.”

“Instead of helping patients know their out-of-pocket costs, this rule will introduce widespread confusion, accelerate anticompetitive behavior among health insurers, and stymie innovations in value-based care delivery,” the hospital groups wrote. “America’s hospitals and health systems have repeatedly urged CMS to work with hospitals, doctors, insurers, patients, and other stakeholders to identify solutions to provide patients with the information they need to make informed health care decisions and know what their expected out-of-pocket costs will be.”

The Blue Cross Blue Shield Association and the Alliance of Community Health Plans also don’t support the new rule.

“Unfortunately, the rules the administration released today will not help consumers better understand what health services will cost them and may not advance the broader goal of lowering health care costs,” BCBSA CEO Scott Serota said in a statement.

The Trump Administration, on the other hand, argues that the new rule is important for lowering healthcare costs amid a surge of surprise medical bills for patients, who often don’t know the full costs of their medical care until they receive the bill.

Prices for healthcare vary dramatically depending on a few factors, such as whether a provider is in or out of the patient’s insurance network and what price the hospital negotiated with the insurance company.

“Our goal was to give patients the knowledge they need about the real price of health care services, so they can shop for the highest-quality care at the lowest cost,” President Trump said in November while introducing the proposal.

Economists believe that forcing rates into the open may shame some providers into reducing their prices, but many hospitals still have a monopoly power in their markets. Emily Gee, a health economist at the left-leaning Center for American Progress, said that transparency won’t work if there’s no competition.

“The rule is a gesture in the right direction, but transparency needs to be accompanied by much stronger policies in order to rein in hospital costs,” Gee said.

 

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