Trump to expand, enforce healthcare price transparency

President Trump is doubling down on healthcare price transparency in a new executive order seeking to ramp up enforcement of requirements issued during his last administration.

"The Federal Government will continue to promote universal access to clear and accurate healthcare prices and will take all necessary steps to improve existing price transparency requirements; increase enforcement of price transparency requirements; and identify opportunities to further empower patients with meaningful price information, potentially including through the expansion of existing price transparency requirements," Trump said in the executive order.

During his first term, Trump sought to provide healthcare price transparency to consumers by requiring hospitals to create a consumer-friendly display of pricing information for up to 300 shoppable services and a machine-readable file with negotiated rates for every single service.

Similarly, a rule under the Trump administration also required health plans to maintain a consumer-facing, online tool with pricing information and a file with negotiated rates with providers in addition to out-of-network payments to providers and the actual prices they or pharmacy benefit managers pay for prescription drugs.

The healthcare price transparency requirements sought to empower consumers to obtain  historically opaque pricing information and shop for affordable care.

However, compliance with the requirements has lagged and the Biden administration issued several updates to the requirements, including allowing hospitals to post estimates, formulas or algorithms rather than actual dollars and cents pricing information.

"Hospitals and health plans were not adequately held to account when their price transparency data was incomplete or not even posted at all," Trump said.

The executive order seeks to reverse murky pricing requirements by requiring hospitals to post actual prices of items and services, not estimates, within 90 days.

Additionally, the executive order also directs the Secretaries of the Treasury, Labor and HHS to issue guidance or propose regulatory action ensuring standardized pricing information across hospitals and health plans and enforcement policies to ensure compliance with healthcare price transparency requirements.

CMS can impose civil monetary penalties on hospitals for failing to comply with the healthcare price transparency requirements. However, the agency has only issued 18 penalties, to date, despite widespread noncompliance. Seven of those penalties are also under review.

In an emailed statement, Cynthia Fisher, founder and chairman of PatientRightsAdvocate.org, said that "[r]eal prices will forever transform the American healthcare system." The nonprofit organization has advocated for healthcare price transparency, including dollar and cents pricing for consumers.

"Price transparency unleashes competition and shifts the power to the true purchasers of care — patients, employers, and taxpayers — allowing them to lower their costs and be protected from overcharges," Fischer continued. "Why would anyone pay $3,000 for an MRI when they could get the same quality for $300? Likewise, no patient would agree to pay a $12,000 colonoscopy bill when the fair market price is around $1,000." 

Power to the Patients supporters Jon “Bones” Jones and Fat Joe also supported the expanded healthcare price transparency order. Power to the Patients recently tapped Jones to star in a Super Bowl LIX public service announcement calling for "more affordable and accessible healthcare through real prices and systemwide price transparency."

Nine out of ten Americans support healthcare price transparency, according to a recent poll.

Jacqueline LaPointe is a graduate of Brandeis University and King's College London. She has been writing about healthcare finance and revenue cycle management since 2016.