A panel of appellate judges is having a hard time understanding the hospital field’s hesitancy to share upfront pricing for x-ray exams.
That’s according to a recent (virtual) courtroom account, detailing arguments in a high-profile appeals case. The American Hospital Association is arguing that it is unlawful for the feds to compel its members to publish negotiated rates they reach with insurers for imaging exams and other services.
AHA previously challenged the policy in a lower court and lost but is now taking another shot in the D.C. Court of Appeals, Healthcare Dive reported. Pressed on why hospitals cannot produce such information, attorney Lisa Blatt said, “many rates are unknowable.”
But judges weren’t buying the argument, launching a line of questioning, according to the report.
“Why is that not doable? Why is it only after Judge Garland leaves the hospital that you know how much to put on Judge Garland's x-ray charge?" Judge Merrick Garland asked.
Blatt responded that x-ray charges are sometimes billed on a volume discount, per diem, or in a way that’s not easily itemized. But the court continued to express skepticism. “Why? It's just an x-ray? If I have one, I'll get charged for $100; and if he gets two, he'll get $200,” said Judge David Tatel.
Read more of the account from Healthcare Dive below.
Marty Stempniak has covered healthcare since 2012, with his byline appearing in the American Hospital Association's member magazine, Modern Healthcare and McKnight's. Prior to that, he wrote about village government and local business for his hometown newspaper in Oak Park, Illinois. He won a Peter Lisagor and Gold EXCEL awards in 2017 for his coverage of the opioid epidemic.