Congress members want screws tightened on radiology providers who ignore price transparency rule

Lawmakers want Health and Human Services to tighten the screws on providers who are ignoring a new price transparency rule that took effect Jan. 1.

The legislation requires hospitals to provide upfront pricing for certain “shoppable” services — including 13 specified radiology exams — to help patients find the best deal. First finalized in November 2019, officials delayed implementation to give providers more time to prepare.

However, a recent Health Affairs analysis found that 65 of the country’s 100 largest hospitals were “unambiguously noncompliant” with the law. Taking umbrage with the findings, members of the House Committee on Energy & Commerce want HHS Secretary Xavier Becerra to punish laggards.

“We are concerned about troubling reports of some hospitals either acting slowly to comply with the requirements of the final rule, or not taking any action to date to comply,” bipartisan members of the committee wrote April 13. “We urge you to ensure that that the Department of Health and Human Services conducts vigorous oversight and enforces full compliance with the final rule.”  

Chairman Frank Pallone Jr., D-N.J., and colleagues want HHS to “revisit its enforcement tools” to boost compliance. Possible responses could include hospital audits and civil monetary penalties, they wrote.

The Hospital Price Transparency Final Rule stipulates that providers must make public a machine-readable file that contains a list of standard costs for its items and services. That includes displaying charges for the hospital’s 300 most shoppable services in a consumer-friendly format, the committee noted. CMS has specified 70 of the services, with more than a dozen in imaging, such as MRI scans of leg joints or X-rays of the lower back. A Wall Street Journal investigation recently found that some hospitals have used special embedded coding to block information from appearing on search engines. Others have buried price details under layers of webpages, House representatives noted.

Committee members are requesting a staff briefing with HHS on the final rule to learn more about how the agency is auditing hospitals. You can read their full letter to Becerra here.

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