President Donald Trump issued an executive order on price transparency requirements in the health care industry on Feb. 25.
“You’re not allowed to even talk about [prices] when you go into a hospital or see a doctor, and this allows you to talk about it,” Trump said of the executive action.
The order aims to gain greater compliance with a federal regulation issued during Trump’s first administration.
Issued in 2019, the Transparency in Coverage regulation requires group insurers and health plans to make data on their in-network payment rates publicly available in order to increase price competition and reduce prices.
“Unfortunately, progress on price transparency at the Federal level has stalled since the end of my first term,” Trump wrote in this latest executive order.
“Hospitals and health plans were not adequately held to account when their price transparency data was incomplete or not even posted at all.”
For example, the report found that rates for knee replacement surgeries were reported for some dentists and optometrists, who do not perform that procedure.
Also, several rates were given for the same service in the same network at the same hospital in some instances, making it impossible to know which rate would apply.
The Make America Healthy Again order directs the secretaries of Treasury, Labor, and Health and Human Services to rapidly enforce the health care price transparency regulations that were issued in 2019.
Within 90 days, the agencies are to require the disclosure of the actual prices of items and services rather than estimates, ensure that medical price information is standardized and easy to compare with other hospitals and health plans, and issue guidance or proposed regulations to ensure compliance with the regulation.
The action is needed because prices vary widely between hospitals in the same region, according to the White House.
A Wisconsin patient saved $1,095 by shopping for the best price on medical tests from two hospitals located just 30 minutes apart, according to a Feb. 25 White House statement.
“One economic analysis found that President Trump’s original price transparency rules if fully implemented, could deliver savings of $80 billion for consumers, employers, and insurers by 2025,” the statement read.
Medical price transparency has been a bipartisan issue in the past. Some measures were enacted in 2021.
The No Surprises Act, effective in 2022, protects consumers from unexpectedly high medical bills from emergency out-of-network providers including air ambulances and non-emergency services at in-network facilities.
Previously, an insurance company might reimburse an out-of-network provider far less, especially for emergency services, leaving the patient to pay the difference.
The No Surprises Act requires that emergency services be covered without prior authorization, regardless of whether or not a provider or facility is in the patient’s network.
A related law effective in 2021 requires each hospital operating in the United States to provide clear online price information about its services.
The information must be available in a machine-readable file that includes all items and services, and in a display of services in a consumer-friendly format.
