No. of Recommendations: 1
There are already requirements in place for price disclosures, the hospitals and what not aren't following them:
newsweek.com - Trumps health care cost transparency order what knowA November review from Patient Rights Advocate found that just 21 percent of 2,000 hospitals analyzed were in full compliance of transparency requirements. The Health and Human Services Inspector General also published an audit last year that estimated 46 percent of hospitals are not in full compliance, an even higher projection than Patient Rights Advocate found.
Health care prices have historically been kept private between doctors, hospitals, drug companies and insurance companies. Trump said in a Tuesday fact sheet that his new order would "give patients the knowledge they need about the real price of healthcare services."Who does these rules? And is this a new thing?
us.milliman.com - Full disclosure price transparency for health plansThe Transparency in Coverage final rule was issued by the U.S. Department of Treasury, the U.S. Department of Labor, and the U.S. Department of Health and Human Services (HHS). Collectively, the departments anticipate that the disclosure of provider-specific reimbursement rates will spur competition, ultimately driving costs down.And those were the Departments named in the EO.
What is this rule?
cms.gov - CMS Transparency in CoverageSUMMARY: The final rules set forth requirements for group health plans and health insurance
issuers in the individual and group markets to disclose cost-sharing information upon request to a
participant, beneficiary, or enrollee (or his or her authorized representative), including an
estimate of the individual’s cost-sharing liability for covered items or services furnished by a
particular provider. Under the final rules, plans and issuers are required to make this information
available on an internet website and, if requested, in paper form, thereby allowing a participant,
beneficiary, or enrollee (or his or her authorized representative) to obtain an estimate and
understanding of the individual’s out-of-pocket expenses and effectively shop for items and
services.If you look at the link, you'll see the issuing authorities being the IRS and the Center for Medicare and Medicaid Services. CMS is essentially the government's insurance administrator, rolling up to HHS. It's their jobs to do this sort of thing.
