Hospitals may soon have to post their standard prices for patients online, under a proposed rule unveiled Tuesday by the Trump administration.
Also, the administration is seeking comments on how to stop so-called surprise billing — when patients are charged after unknowingly being seen by out-of-network providers — and how to give patients better information about the out-of-pocket costs they will face.
And officials are ramping up pressure on hospitals to give patients better access to their medical records electronically or face a penalty.
The proposed rule is the Centers for Medicare & Medicaid Services’ latest effort to give patients more information about the cost of health care and about their own medical history so they can better direct their own care. The guidance — part of the annual update to Medicare payment policies — applies mainly to Medicare patients and providers, but officials expect it will influence practices across the nation’s health care system. It would take effect in 2019.
The posted prices, however, may not reflect the actual amount most patients pay since insurers and the government negotiate different rates and often cover a major portion of the bill.
The initiative builds on the Obama administration’s efforts to increase transparency and shift toward paying for the overall health care value of the services provided, rather than simply for the services rendered. Hospitals are already required to provide either a list of their standard charges or their policies for allowing the public to view the prices. Trump officials want hospitals to post this information on the Internet and make it available in a way that third-party app developers can access.
In addition, the agency said they were concerned about out-of-network bills, such as those for anesthesiologists and radiologists who work at in-network hospitals, and by facility and physician fees for emergency room visits that come as a surprise to patients.
The administration is also pressing providers to increase the sharing of information among hospitals so patients could see all their records, regardless of where they go for care. Currently, a hospital often gives patients access to their data through its own online portal.
“Our administration is serious about ensuring that when a patient leaves a hospital, they are able to get their medical information electronically,” said Seema Verma, the agency’s administrator.
The nearly 1,900-page proposed rule also continues President Donald Trump’s mission to reduce regulations and paperwork. It eliminates several dozen quality measures that the agency called “duplicative, overly burdensome or out-of-date.”