According to a new report, less than one-third of Alabama hospitals are complying with a Trump-era rule mandating price transparency online.

As reported by the Foundation for Government Accountability (FGA), only 31% of Alabama hospitals are complying with federal pricing transparency requirements. Nationally, the average is 38%.

Centers for Medicare & Medicaid Services (CMS) announced in 2019 based on an executive order by former President Donald Trump requirements that hospitals make all standard charges for all items and services available online to the public. The rule also requires hospitals to display "shoppable services" pricing in a prominent location online so consumers could see pricing for services like x-rays, outpatient services, and pre- and post-delivery care. 

The rule went into effect in January 2021 despite an unsuccessful legal challenge by the American Hospital Association.

According to the FGA report, approximately 63% of hospitals nationally have "refused to disclose cash prices, negotiated rates with private insurance plans, prices for some services, or even any prices at all."

"Across the country, hospitals are hiding the true cost of health care in violation of federal price transparency requirements," Hayden Dublois, FGA Data and Analytics director, told 1819 News. "Alabama is not immune--just 31% of Alabama hospitals are compliant with price transparency rules, which is below the national average and every one of Alabama's neighboring states. Federal lawmakers should hold CMS accountable and press them to actually enforce these rules. In the absence of federal action, Alabama policymakers can pass their own price transparency requirements to sanction hospitals that are refusing to comply. Alabamians deserve to have transparent hospital prices."

A spokeswoman for the Alabama Hospital Association didn't return a request for comment.

Hospitals could be penalized with fines under the rule for non-compliance. According to FGA, the Biden administration "nominally increased potential penalties for non-compliance. It has done little to actually enforce the rule or impose those penalties." Atlanta-based Northside Hospital received the first fine handed down by CMS of a little over $1 million in June 2022 for non-compliance with the rule, according to Becker's Hospital CFO Report.

David Ralston, assistant vice president of revenue cycle at Jackson Hospital in Montgomery, told Healthcare Innovation in October 2020 that the price estimator tool was a "patient satisfier, since it gives consumers a true representation of what the procedure will cost in total, what it will cost the patient himself or herself, as well as what the insurance coverage amount is." 

"The patient knows exactly what they're in for before having the procedure," Ralston said. "And if the patient needs to reschedule, or we need to [create] a patient loan or payment plan, or we determine that the patient needs a financial clearance to make a payment, we can make that happen ahead of time. It really takes the burden off the patient and lets them think about the procedure and healing since the financial side has already been taken care of."

The FGA report was based on transparency compliance data on 6,431 hospitals in all 50 states and the District of Columbia from Turquoise Health, a data services company that collects hospitals' price information. 

Search here for a summary of how well or not well your local hospital is complying with the price transparency rule on Turquoise Health.

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