A federal judge has upheld a Trump administration policy that requires hospitals and health insurers to publish their negotiated prices for health services, numbers that are typically kept secret.
The policy is part of a major push by the administration to improve transparency in health care. Insurers and health providers usually negotiate deals behind closed doors, and patients rarely know the cost of services until after the fact.
Administration officials said more price transparency would lead to lower and more predictable prices in an industry that has huge ranges in what insurers pay for services. A simple blood test, for example, can cost $11 or $1,000. Coronavirus tests show a similar variation, with prices from $27 to $2,315.
But in a lawsuit, the American Hospital Association said the administration did not have the legal authority to require the publication of negotiated prices, arguing that the publication of the prices could have perverse effects. On Tuesday, the judge, Carl Nichols, disagreed.
ruth000 on June 24th, 2020 at 18:23 UTC »
It's not just about lowering prices, as the article seems to state. It's also about the simple, irrefutable fact that you have a right to make informed financial choices.
IndigoAspen on June 24th, 2020 at 16:39 UTC »
When I worked in the ER as a medic, we were tasked to reorder, stock, & fill the trauma bays. When I saw what we pay vs what we charge just for a neck brace, I got sick to my stomach. $30 some bucks is what we pay, while charging $300.
Edit: typos
Julian_Caesar on June 24th, 2020 at 16:07 UTC »
This is a great step. Those of us in the medical community who care about patients have been pushing this for a long time. It's bad enough outside the hospital, where a CT scan costs $250 cash but will "charge" insurance $4000 for the same thing... knowing that insurance will "adjust" down to a price that has been negotiated on the golf course.
And it's way worse in the hospital. Bags of IV saline do not cost hundreds of dollars to buy OR administer...but this is the "price" sent to insurance. So that they can "adjust" how much they pay, or not "adjust." Depending on factors that are completely opaque.
The end result is that hospitals and insurance do a never-ending dance of opacity. And in the end the patient foots the bill for the waste.