Local health giants oppose CMS price transparency rule
NOT FOR EXTERNAL DISTRIBUTION
SOURCE: Nashville Post
AUTHOR: Kara Hartnett
National health organizations representing several local hospitals and health systems, among others, have expressed their intent to file suit against the Centers for Medicare and Medicaid Services for a finalized rule released last week that's associated with the Trump administration’s push for more price transparency.
The new CMS rule will mandate that all hospitals publicize by 2021 their charges for 300 health services available to patients at rates negotiated with insurance companies. CMS will identify 70 services for which hospitals must publish pricing data and allows flexibility for the hospital to choose the other 230.
The national organizations pushing back on the new rule include the American Hospital Association, the Association of American Medical Colleges, the Children’s Hospital Association and the Federation of American Hospitals. In a joint statement on their intent to file a legal challenge, the groups said:
Today’s rule mandating the public disclosure of privately negotiated rates between commercial health insurance companies and hospitals is a setback in efforts to provide patients with the most relevant information they need to make informed decisions about their care. 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. 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. We continue to stand ready to work with CMS to achieve this goal.
Because the final rule does not achieve the goal of providing patients with out-of-pocket cost information, and instead threatens to confuse patients, our four organizations will soon join with member hospitals to file a legal challenge to the rule on grounds including that it exceeds the Administration’s authority.
Local health giants such as HCA Healthcare and Vanderbilt University Medical Center are members of these national organizations and adamantly support these efforts to stamp out the policy. But officials there say they do not have plans to pursue individual legal action against the rule.
“VUMC is member of the Association of American Medical Colleges, the American Hospital Association and the Children’s Hospital Association, each of which have indicated they will challenge the CMS price disclosure rule on behalf of their member institutions,” VUMC said in a statement to the Post. "VUMC supports the efforts by these associations and others to challenge the legality of this rule, but does not at this time intend to join any proposed legal challenge as an institutional plaintiff."
Nashville-based HCA also is a member of the American Hospital Association, and executives said in a statement that they “fully support their position” but will not be taking individual legal action at this time.
Other major local players like Community Health Systems and Ascension Saint Thomas Health declined to comment their position on the new rule. However, St. Louis-based Ascension has been in the spotlight of late for another initiative aimed at consolidating health data.