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Statements of Public Disclosure of Privately Negotiated Rates Final Rule


 

Joint Statement from National Hospital and Health System Groups on Public Disclosure of Privately Negotiated Rates Final Rule

The American Hospital Association (AHA), Association of American Medical Colleges (AAMC), Children's Hospital Association (CHA) and Federation of American Hospitals (FAH) issued the following joint statement on today's final rule from CMS:

Today's rule mandating the public disclosure of privately negotiated rates between commercial health insurance companies and hospitals is a setback in efforts to provide patients with the most relevant information they need to make informed decisions about their care. Instead of helping patients know their out-of-pocket costs, this rule will introduce widespread confusion, accelerate anticompetitive behavior among health insurers, and stymie innovations in value-based care delivery. America's hospitals and health systems have repeatedly urged CMS to work with hospitals, doctors, insurers, patients, and other stakeholders to identify solutions to provide patients with the information they need to make informed health care decisions and know what their expected out-of-pocket costs will be. We continue to stand ready to work with CMS to achieve this goal.

Because the final rule does not achieve the goal of providing patients with out-of-pocket cost information, and instead threatens to confuse patients, our four organizations will soon join with member hospitals to file a legal challenge to the rule on grounds including that it exceeds the Administration's authority.


AHIP Comments on Rules Requiring Public Disclosure of Negotiated Prices

WASHINGTON, D.C. - (November 15, 2019) - Matt Eyles, president and CEO of America's Health Insurance Plans (AHIP), issued this statement following the release of two rules - one final, one proposed - that would require public disclosure of privately negotiated rates between hospitals and health insurance providers:

"Every American should be able to get personalized health care cost and quality information before they seek care. Actionable and personalized information will help patients make informed decisions that are best for their needs. We support clear, consistent and concise information that is customized to an individual's circumstances. Transparency should aid and support patient decision-making, should not undermine competitive negotiations that lower patients' health care costs, and should put downward pressure on premiums for consumers and employers.

"As we evaluate the full impact of both the final and proposed rules released today, and how they interact with other proposed rules that impact patient and consumer data, we do so with a few key principles in mind:

  • Consumers deserve transparency about out-of-pocket costs to help them make informed decisions about their own care.
  • Transparency should be achieved in a way that encourages - not undermines - competitive negotiations to lower patients' and consumers' costs and premiums.
  • Public programs and the free market should work together to deliver on our commitments to affordability, quality and value for Americans.

"Neither of these rules - together or separately - satisfies these principles.

"Health insurance providers unequivocally want to empower patients and consumers with health care cost and quality information that is simple, clear, and personally relevant. That is why health insurance providers encourage all of their consumers to use the secure, personalized cost estimator tools they provide today. We will continue to engage collaboratively with the Administration and other health care stakeholders on how we can best work together to achieve lower prices and costs while protecting health care quality, choice, value, and privacy for the hardworking Americans we serve."

 
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