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Most Hospitals Non-Compliant with Federal Price Transparency Rules

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1.5 minute read

A recent report from PatientRightsAdvocate.org (PRA) revealed that just one-third (34.5%) of hospitals fully adhered to the federal Hospital Price Transparency Rule. Out of the 2,000 hospitals assessed nationwide, only 689 met the compliance standards. These latest findings mirror last year's results, with a steady 36% compliance rate.

The Hospital Transparency Rule has required all hospitals to post prices publicly online since January 1, 2023. Here are some key report findings of the 2,000 hospitals surveyed:

  • 5% were fully complaint with the rule
  • 5% were not fully compliant with the rule
  • 4% are in total noncompliance
  • 135 hospitals showed a regression, indicating they were not compliant this year after being compliant in the previous report

The PRA report revealed that no hospitals owned by the largest hospital were fully compliant. Many hospitals are posting multiple files instead of the required single file, and the Centers for Medicare & Medicaid Services is not strongly enforcing the rule, issuing penalty notices to only 14 hospitals. This lenient enforcement may be causing hospitals to disregard the federal rule.


Employer Takeaway

Hospital price transparency allows Americans to make informed decisions, avoid billing errors, and lower healthcare costs. Despite this, many Americans face medical debt due to undisclosed charges. Employers can benefit from studies like the PRA report to become better-informed purchasers of healthcare services and should monitor healthcare trends, utilization, and spending. Download the bulletin for more details.

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National Insurance Services is not a law firm and no opinion, suggestion, or recommendation of the firm or its employees shall constitute legal advice. Readers are advised to consult with their own attorney for a determination of their legal rights, responsibilities and liabilities, including the interpretation of any statute or regulation, or its application to the readers’ business activities.

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Steve Smith

Steve Smith

Steve Smith, Employee Benefits Consultant for National Insurance Services, has his energy level permanently set at “high.” His maxim is “work hard, play hard.” Steve’s an expert in getting groups of people working together for a higher cause. Minnesota schools, cities, and counties rely on Steve’s unique and creative ideas of engaging employees in their own health and wellness to lower utilization trends. He has 20+ years in the health insurance field doing compliance, cost mitigation, utilization, analytics, wellness plans, and strategic planning. Steve is a licensed insurance agent and holds the designations for Managed Healthcare Professional (The Health Insurance Association of America), Certified Patient Protection and Affordable Care Act Professional (National Association of Health Underwriters), and Group Benefits Disability Specialist (Hartford School of Insurance). He specializes in Employee Benefits Consulting for Minnesota schools, cities, and counties including fully insured, self-insured, and stop-loss plans.