HOUSTON – Imagine shopping online for a colonoscopy or heart surgery just like we shop for airline tickets. You type in what procedure you need and you get a list of prices from hospitals that show what you would pay with and without insurance. That is the idea behind the Hospital Price Transparency Rule. The federal law that took effect in January says hospitals must release pricing information before providing service.
Are hospitals providing pricing information?
Even though hospitals are now required to publicly disclose standard charges, including the low and high prices for each procedure, non-profit group PatientRightsAdvocate.org recently checked the websites of 500 hospitals across the country at random. The group found only 5.6% of the hospitals are compliant. You can read the full report here.
In the Houston area, PRA’s report shows nine hospitals failed to post prices on their websites as required. They include:
- Baylor St. Luke’s Medical Center
- Houston Methodist- Texas Medical Center
- Houston Methodist Sugar Land
- Harris Health Ben Taub
- HCA Houston Healthcare Kingwood
- Memorial Hermann- Texas Medical Center
- Texas Children’s Hospital
- M.D. Andersom Cancer Center
“We know all of these prices are already digital for those hospitals to get paid,” said CEO and founder of PRA Cynthia Fisher. “They know what the negotiated rate is digitally. They have it on file so that all they have to do is pull back the curtain and let us, the consumers, see their prices easily posted online to comply with this law.”
Texas Children’s Hospital disagrees with PRA’s findings. A hospital spokesperson sent KPRC 2 News the following statement:
“The health and well-being of our patients is Texas Children’s Hospital’s top priority. Since the law went into effect, we have fully complied with the Centers for Medicare and Medicaid Services (CMS) guidelines to provide a complete list of standard charges. We began efforts to improve price transparency several years ago to ensure a positive patient experience by providing patient estimates prior to scheduled services. Texas Children’s remains committed to transparency and strives to educate our patient families regarding their financial obligations. A full list of our standard charges and an estimate tool to understand out of pocket costs are available on our website: http://texaschildrens.org/patients-and-visitors/insurance-billing/know-cost-your-healthcare.”
A spokesperson with Harris Health sent KPRC 2 News an email, writing “Ben Taub Hospital is complying and is listed as part of Harris Health System. This posting represents all of our hospitals, health centers, clinics and specialty facilities.” We have asked Harris Health to send us the link where consumers can find the negotiated rates with insurers on its website.
Some of the hospitals in our area had some information posted, but not all of it. The law requires that the information be easy to read and understand. They also want it to be easy for companies like Google to scrape the data so they can put it all on searchable websites to make prices more transparent.
Keep in mind, PRA’s study only looked at 500 hospitals across the country. There may be more hospitals in the Houston area that do not comply. Currently, the federal fine for non-compliance is up to $300 a day. The Centers for Medicare and Medicaid Services has proposed increasing the fine up to $2 million a year for hospitals that do not get on board.
If you notice that a hospital does not have prices posted online that are easy to read and understand, you can file a complaint with CMS here.