House Committee Requests Investigation into Federal Hospital Price Transparency Compliance

The House Committee on Energy and Commerce is requesting the Government Accountability Office open an investigation into compliance with the CMS Hospital Price Transparency rule that went into effect in January of 2021.

The House Committee states, “We are concerned with continuing reports of low hospital compliance and some hospitals’ complete lack of compliance," Reps. Frank Pallone Jr. and Cathy McMorris Rodgers wrote in the Nov. 4 letter. "We are also troubled by reports that some hospitals disclosing their prices are making it difficult for consumers to access the price information."

Recent studies by researchers and advocacy groups have shown relatively low compliance with the price transparency rule, including some of the largest health systems in the country. A recent report, however, found that hospital compliance with the rule is beginning to steadily increase.

The House Committee has requested the GAO look into the requirement that hospitals provide a comprehensive machine-readable file (preferably in the JSON data format) of all items and services, including standard charge data and payer-negotiated rates.?Hospitals initially pushed back, stating the cost, complexity, and administrative burden of gathering and creating the required compliance resources.

The House Committee has requested the Government Accountability Office to provide answers to the following questions:

1. To what extent are hospitals complying with the requirement to make public a machine-readable file containing a list of all the standard charges for all items and services?
2. To what extent are hospitals complying with the requirements regarding the online posting of a machine-readable list of hospital standards and charges, as well as a consumer-friendly list of the 300 shoppable services and their prices?
3. To what extent is the price information easily accessible for consumers, including whether the price information is readily displayed?
4. How is CMS monitoring and enforcing hospitals' compliance with the rule, including what steps is CMS taking to ensure compliance? To what extent has CMS taken action against hospitals noncompliant with the final rule?

Are you unsure if your hospital is meeting the federal and state-level hospital price transparency requirements? Contact ClaraPrice today for a complementary assessment.

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