Hospitals lose opportunity to keep rates negotiated with insurers secret


The landmark rule stems from an executive order issued by President Donald Trump last summer. The administration argues that such price transparency will help reduce health care costs.

The administration hailed the decision, saying that American patients deserve to be in control of their health care.

“Especially when patients seek the necessary care during a public health emergency, it is more important than ever that they have immediate access to the real prices of health care services,” said Secretary of Health and Human Services Alex Azar.

The American Hospital Association, one of the plaintiffs, promised to appeal the ruling and request an expedited review.

“The proposal does nothing to help patients understand their out-of-pocket costs. It also imposes significant burdens on hospitals at a time when resources are depleted and must be devoted to patient care,” said Melinda Hatton, general counsel. of the group. . “Hospitals and healthcare systems have consistently supported efforts to provide patients with information about the costs of their healthcare. This is not the right way to achieve this important goal.”

The plaintiffs, which include the Association of American Medical Colleges, the Federation of American Hospitals, the National Association of Children’s Hospitals and three hospitals, argued that disclosing fees could confuse patients because those prices are different from their out-of-pocket obligations. The amount consumers actually pay for hospital services depends on their insurance plans, including their deductibles, and the amount of medical care they have received during the year.

The rule also requires hospitals to disclose the amounts they are willing to accept in cash for an item or service. They must provide all of this information in an online search for 300 common services, such as x-rays, outpatient visits, and laboratory tests. Non-compliant hospitals face a civil penalty of up to $ 300 per day.

The administration also proposed a separate rule that would require insurers to provide consumers with estimates of their out-of-pocket costs for all health care services through an online tool. Operators would have to disclose their negotiated rates for in-network providers, as well as the allowed amounts paid by out-of-network providers.

However, some experts say the rules won’t help many consumers because people often don’t buy medical services.

The district court’s decision comes a week after the Trump administration lost another legal round in its bid to require pharmaceutical companies to disclose prices in their television commercials. A federal appeals court ruled that the administration lacked the authority to do so.

This story has been updated with the reaction of one of the plaintiffs.

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