Report: Over half of Illinois hospitals not complying with price transparency law

[July 26, 2023]  By Kevin Bessler | The Center Square

(The Center Square) – Despite a federal law being on the books for nearly three years, a report shows that many Illinois hospitals are not revealing their prices online.

PatientsRightsAdvocate.org has issued its semi-annual report that showed 40% of the Illinois hospitals they checked are complying with the law.

PRA compiled and made public the standard charges files for all 2,000 hospitals around the country reviewed in the latest report. Only 721 (36%) hospitals were fully complying with the rule, but an increase of 11.5% from February.

“Unfortunately, our findings show that the majority of hospitals across the country are still failing to comply with the Hospital Price Transparency Rule,” said PRA founder Cynthia Fisher. “When hospitals hide behind estimates or don’t post all real prices, they are leaving consumers in the dark.”

Fisher said a significant number of hospitals posted encoded, complex files without user documentation, or complicated formats making them unusable in some cases.

The federal Hospital Price Transparency Rule, which took effect on Jan. 1, 2021, requires hospitals to post all prices online, easily accessible and searchable, in the form of (1) a single machine-readable standard charges file pricing for all items, services, and drugs by all payers and all plans, the de-identified minimum and maximum negotiated rates, and all discounted cash prices, as well as (2) prices for the 300 most common shoppable services either as a consumer friendly standard charges display listing actual prices or, alternatively, as a price estimator tool.

The Centers for Medicare and Medicaid Services is in charge of enforcing compliance, and as the PRA noted, two hospitals that were previously penalized monetarily came into compliance soon after.

“As of the time of this report, a total of four hospitals have been penalized, 0.2% of the hospitals that CMS recognized as noncompliant. Clearly, CMS is not strongly enforcing the rule,” the nonprofit said.

PRA sent letters to President Joe Biden and Congress sharing the findings of the report and asking them to step up enforcement efforts.

“Nearly 90% of Americans agree that hospitals, providers, and health insurers should be required to post their prices online for everyone to easily access,” said Fisher. “While we are encouraged by the growing momentum behind this movement, now is the time for Congress to stand up for all healthcare consumers by passing legislation to codify, strengthen, and enforce the price transparency rules to create a more affordable, competitive healthcare system for everyone.”

The U.S. House Energy and Commerce Committee recently took action to strengthen hospital price transparency by introducing the PATIENT Act, which received unanimous support in a committee vote to advance the bill.