According to a recent report by the nonprofit Patient Rights Advocate (PRA), only about one-third of hospitals are currently compliant with federal hospital price transparency rules that went into effect more than two years ago.
The PRA’s fifth semi-annual report reveals that out of 2,000 surveyed hospitals, only 36 percent were found to be fully compliant with the rule.
As of January 1, 2021, hospitals have been required to provide “clear, accessible pricing information” for their products and services, either through an online file or a user-friendly display of shoppable services.
The PRA’s report specifically highlights that while most hospitals have posted price files, 64 percent of them had incomplete or unclear pricing information associated with payers and plans. Additionally, 69 hospitals (3.5 percent) did not have usable files for charges.
Although less than half of all hospitals were found to be fully compliant, this represents an improvement from the 25 percent compliance rate reported in February.
The data for this report was collected from publicly available hospital websites between May 9 and July 14.
“Noncompliance with the rule continues to hinder the ability of employers, unions, patients, and technology developers to analyze and compare prices,” states the PRA in its report.
The PRA also examined the enforcement of penalties and noted that the Centers for Medicare and Medicaid Services (CMS), responsible for enforcing compliance, had previously penalized two hospitals, both of which came into compliance shortly after.
“In February 2023, CMS acknowledged in a blog post that 30% of hospitals (approximately 1,800) were still noncompliant,” reported the nonprofit.
“Yet, in April 2023, only two more hospitals were fined. Both were still found to be noncompliant in this review. As of the time of this report, a total of four hospitals have been penalized, representing 0.2% of the hospitals recognized as noncompliant by CMS. Clearly, CMS is not strongly enforcing the rule,” added the PRA.
The PRA has sent letters to congressional leaders and President Biden, outlining its findings and urging further action to improve hospital price transparency and compliance with the existing rule.
Among the PRA’s recommendations are “increased, meaningful fines for noncompliance,” closing loopholes that allow hospitals to bypass the rule, and expanding price disclosure requirements to include all healthcare providers.
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