Newspaper: Georgia Hospitals Bypassing Pricing Requirements

Newspaper: Georgia Hospitals Bypassing Pricing Requirements

The rates for at least 300 services had to be published in a consumer-friendly manner. Hospitals also had to publish all their charges in a format that could be read on the internet by other computer systems. That would allow web developers and consumer groups to come up with tools that patients and their families could use. The American Hospital Association opposed the rules, saying the disclosure of privately negotiated rates would not help patients understand what they would actually pay for treatment. It also argued that insurers could use the information to squeeze hospitals, and hospitals needed to focus their resources on fighting the COVID pandemic.

The newspaper said Friday it reviewed 14 Georgia hospitals and found that as of early July, only one made prices easy to find, and nearly half failed to meet key requirements of the pricing transparency mandate. Under rules finalized by the Trump administration, hospitals starting on January 1 were required to disclose their privately negotiated charges with commercial health insurers as well as any discounted price for consumers paying cash. “It is important to understand that good-faith efforts to meet the new requirements can come at a cost,’′ Molly Smith, vice president for public policy for the American Hospital Association, told the AJC in a statement. “Pressures of fighting the virus did not go away because of the January 1 deadline.”

The Centers for Medicare and Medicaid Services on Monday proposed increasing the penalty for hospitals that do not comply with the rules, saying it had heard concerns from consumers about compliance. The AJC found that most of the 14 hospitals it reviewed did not disclose specific prices. CMS allows hospitals to skip the requirement by providing a tool that allows patients to calculate their estimated cost for a procedure, the AJC said. Critics say that tool does not provide equivalent transparency.

The AJC said several hospitals had multiple data fields missing, and only Memorial Health in Savannah displayed the price data in a prominent location — the top half of the hospital’s home page.

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