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- Executive Order: Health Care Price Transparency
The White House is renewing an effort to increase the transparency of prices for health care services. As was first proposed several years ago, President Donald J. Trump has now directed the departments of Health and Human Services, Treasury, and Labor to ensure hospitals and insurers disclose actual prices for medical services instead of releasing estimates for services.
The original regulations, finalized between 2019 and 2020, require hospitals to maintain a consumer-friendly display of pricing information for up to 300 shoppable services, and a machine-readable file with negotiated rates for its services. They also impose requirements on health plans.
The executive order signed on February 25 also directs the departments to update enforcement policies to ensure hospitals and insurers are in compliance with statutory requirements to make prices transparent to the public. In a communication from February 28, the Centers for Medicare & Medicaid Services (CMS) commented that "consistent with standing CMS policies, non-compliance will be addressed with swift enforcement." See a list of enforcement actions to date and see a list, updated quarterly, of enforcement activities and their outcomes undertaken by the CMS since the January 1, 2021, effective date.
The CAP previously commented on both proposed regulations - the hospital price transparency and the transparency in coverage regulations. In general, the CAP agrees that patients must be able to make informed decisions about their health care, and we understand how access to price information prior to services may be useful for patients. However, the CAP is concerned about risks for patient harm from any delays and difficulty in determining the cost of pathology services in advance of services conducted by the pathologist.
Additional resources available:
- Hospital Price Transparency Tools
- Data Dictionary GitHub Repository
- For any questions related to hospital price transparency, email PriceTransparencyHospitalCharges@cms.hhs.gov.