- Patients deserve to know how much their hospital care will cost before they receive care, HHS argued in a brief filed Tuesday in response to a lawsuit challenging the agency's price transparency rule.
- HHS argued that Congress intended for hospital prices to be made public, pointing to the Public Health Service Act passed in 2010, which calls for hospitals to share their standard charges. The rule in question defines which standard charges must be made public, the agency said.
- The brief also pushed back on claims the rule violates the First Amendment, arguing it advances the government's interest in providing consumers with better information and does not chill any protected speech.
As patients bear the brunt of healthcare costs amid rising deductibles, a push to inject more transparency into the healthcare sector so patients can make informed choices for care has gained steam.
Forcing the secret, negotiated rates between hospitals and payers would be a landmark shift in the nation's healthcare systems, in which most patients have scant information on even estimated costs of care before receiving services.
These efforts by the Trump administration have not been well-received by the industry and hospitals sued HHS in December, arguing the policy exceeds the government's authority and violates the First Amendment by forcing hospitals to reveal confidential and proprietary information.
HHS has claimed that the transparency push will ultimately lower healthcare prices and took a jab at the industry: "If patients pay less for healthcare, however, someone else receives less. Therein lies the genesis of this suit."
In its rebuttal to the challenge from hospitals, HHS claimed price information is already public in a patient's explanation of benefits. That EOB typically arrives after care is provided and many patients have decided to share that information on the internet to help other patients, according to the brief. That information is just "sitting in the file cabinets and inboxes of millions of patients who are free to share those rates with the world."
Hospitals contend that releasing negotiated rates will only confuse consumers because it does not tell patients what they may owe after factoring in their co-pays and deductibles.
HHS rejected this narrative and said hospitals are only aiding the confusion.
"They do not dispute that consumers are casting about for accurate information about prices in a complex healthcare system, yet they rely on that same complexity as an affirmative reason to deprive patients of pricing information they need to figure out their out-of-pocket expenses," HHS said.
In the hospitals' challenge, they also argued it will overwhelm providers in trying to publish that information but HHS contended it would "impose manageable administrative costs on hospitals."