Dive Brief:
- The Federal Trade Commission is warning hospital systems of serious regulatory repercussions if they fail to disclose timely and accurate healthcare prices to consumers.
- FTC Chairman Andrew Ferguson sent letters to two dozen major hospital operators on Monday threatening scrutiny from both the antitrust agency and the HHS if they don’t publicly post costs for their services. The agency did not identify which hospitals received the letters and declined to share a list of them.
- It’s the latest attempt by the Trump administration to increase price transparency in healthcare, after finalizing a regulation Monday strengthening disclosure requirements for insurers.
Dive Insight:
Price transparency has been a priority for health officials in both the first and second Trump administrations, who claim clear, publicly reported pricing among hospitals and insurers will help patients shop for care, spur market competition and eventually drive down medical costs.
At the urging of President Donald Trump, the CMS finalized a rule in late 2019 requiring hospitals to publicly post their standard charges, including negotiated rates with insurers, in two ways: as a machine-readable file and a consumer friendly display of for 300 “shoppable” services. Regulators started enforcing the rule in 2021, and recently tacked on new requirements to make data files more readable, increase accountability and add contextual pricing metrics so patients can better compare care.
However, hospitals have lagged on compliance. More than half of hospitals are still not fully compliant with the CMS’ hospital price transparency rule, transparency advocacy group PatientRightsAdvocate.org said in September.
The second Trump administration has pressured the CMS to more aggressively enforce price transparency. The agency has fined 28 noncompliant hospitals since 2021, with roughly a third of those penalties divvied out since Trump took office at the start of last year.
Now, the FTC is weighing in, reminding hospitals that they must comply with the federal FTC law in addition to the CMS rule.
The agency says hospitals could violate the law by failing to post prices for their services, given not disclosing the information could be considered deceptive and likely to mislead consumers.
Hospitals could also be in violation if they post incomplete pricing, like excluding extra fees, which could mislead a patient into believing they know the total cost of care. The CMS rules serve merely as a “regulatory floor” but do not provide safe harbor from the FTC, according to Ferguson.
The FTC letters align with regulation finalized Monday from the HHS and Labor and Treasury Departments, which attempts to patch gaps in price transparency requirements for insurers. The revamped version of the insurer price transparency rule is meant to strip away junk data and standardizing file formats to make price information more readable.
