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White House wins ruling on disclosing health care prices

Associated Press

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FILE - In this July 9, 2019 photo, Dr. Jori Fleisher, neurologist, examines Thomas Doyle, 66, at the Rush University Medical Center in Chicago. (AP Photo/Teresa Crawford)

WASHINGTON (AP) — A federal judge on Tuesday ruled in favor of the Trump administration’s plan to require hospitals and insurers to disclose the actual prices for common tests and procedures.

The ruling rejected the American Hospital Association’s challenge to the plan. The rule mandates that hospitals disclose their privately negotiated charges with commercial health insurers. It is scheduled to take effect Jan. 1, 2021.

Melinda Hatton, general counsel for the American Hospital Association, said it supports price transparency and making patients’ out-of-pocket cost estimates easier to access and understand, but is disappointed with the ruling.

“The AHA continues to believe that the disclosure of privately negotiated rates does nothing to help patients understand what they will actually pay for treatment and will create widespread confusion for them,” Hatton said in a statement.

“We also believe it will accelerate anticompetitive behavior among commercial health insurers and hinder innovations in value-based care delivery. Lastly, the requirement imposes significant costs on care providers at a time when scarce resources are needed to fight COVID-19 and save lives.”

The hospital association has urged President-elect Joe Biden to review the rule. The industry argues that forcing the disclosure of prices negotiated between hospitals and insurers amounts to coercion.

As proposed, the Trump administration rule would require that hospitals:

— Publish in a consumer-friendly manner negotiated rates for the 300 most common services that can be scheduled in advance, such as a knee replacement, a Cesarean-section delivery or an MRI scan. Hospitals would have to disclose what they’d be willing to accept if the patient pays cash. The information would be updated every year.

— Publish all their charges in a format that can be read on the internet by other computer systems. This would allow web developers and consumer groups to come up with tools that patients and their families can use.

Insurers also oppose the plan, saying it could prompt providers that are accepting a bargain price to try to bid up what they charge if they see that others are getting more. A separate regulation that applies to insurers has not been finalized.

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