Energy and Commerce Chairman Frank Pallone, Jr. (D-NJ) and Ranking Member Cathy McMorris Rodgers (R-WA) sent a letter to Secretary of Health and Human Services Xavier Becerra in support of the 2022 Medicare Outpatient Hospital Prospective Payment Rule’s provisions to increase penalties for hospitals not in compliance with the Hospital Price Transparency Final Rule.
Their letter states:
“We write today in support of the provisions in the 2022 Medicare Outpatient Hospital Prospective Payment Rule, released on July 19, 2021, that seek to increase the effectiveness of the Hospital Price Transparency Final Rule, which went into effect on Jan. 1, 2021. This proposed rule would increase penalties for hospitals not in compliance with the Hospital Price Transparency Final Rule, effective Jan. 1, 2022, which follow reports of concerningly high rates of hospital noncompliance with the final rule.
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“A Health Affairs survey on hospital noncompliance found that 65 of the largest 100 U.S. hospitals were noncompliant as of early February. Another report, issued July 2021 by the Patient Rights Advocate, found that only 5 percent of hospitals were fully compliant with the rule. Additionally, in your May 11, 2021 response to a bipartisan letter from Energy and Commerce Committee leadership, you stated the agency’s intention to issue civil monetary penalties to hospitals failing to submit corrective action plans or comply with the requirements of the final rule. We are glad that CMS has sent over 100 warning letters thus far and support the Department’s efforts to conduct vigorous oversight and ensure full compliance with the final rule.
“Available analyses of existing price transparency measures among compliant hospitals further demonstrates the need for the agency to enforce full compliance with the rule. A New York Times investigation found that in many instances, patients insured under commercial plans were paying more in out-of-pocket costs for services than they would have if they had no health coverage at all. Even within the same hospital system, standard charges negotiated by insurers result in significant price variation across hospital sites, one Health Care Cost Institute study found. For example, a knee X-ray performed at one of Northern California’s Sutter Health System hospitals may cost up to eight times as much as one performed at an affiliated site. The wide price variation observed across compliance providers, insurers, and hospitals in these analyses highlight the importance of the proposed rule in stepping up the agency’s enforcement actions against noncompliance.
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“We support the Administration’s proposed rule to significantly increase potential penalties on noncompliant hospitals. We also applaud the agency’s commitment to increasing price transparency and empowering consumers and employers to make informed decisions about their health care with meaningful and actionable information about health care prices."
NOTE: On April 13, 2021, Chairman Pallone, Ranking Member Rodgers, Health Subcommittee Chairwoman Anna G. Eshoo (D-CA), and Health Subcommittee Ranking Member Brett Guthrie (R-KY) wrote to Secretary Becerra regarding implementation of the Hospital Price Transparency Final Rule, which went into effect on Jan. 1, 2021, and the need to conduct vigorous oversight to ensure that hospitals are complying with the new rule.
