Consumer advocates and policy experts told Congress more enforcement is needed to improve price transparency compliance.
At a House Energy and Commerce Committee hearing on March 28, Sophia Tripoli, director of healthcare innovation at consumer advocacy group Families USA, told lawmakers some hospitals are not posting fully accessible price transparency files.
"We're seeing hospitals doing everything from not posting pricing information, [or] they're posting the price as a percentage as Medicare, which is meaningless for most consumers. They're publishing information in various formats that are not usable or machine readable," Ms. Tripoli said.
Congress could strengthen oversight by enforcing standard formats for price transparency data, prohibiting hospitals from posting prices as percentages and upping fines for noncompliance, Ms. Tripoli told lawmakers.
Rep. Cathy Rodgers, a Washington Republican and the Energy and Commerce Committee chair, said most hospitals have not complied fully with price transparency requirements.
"We need stronger enforcement from CMS, which to date has only levied two penalties against hospitals for not posting accurate information for patients," Ms. Rodgers said.
CMS has issued nearly 500 warnings and 230 requests for corrective action to hospitals not complying with price transparency laws as of January 2023, two of the agency's leaders wrote earlier this year.
Rep. Anna Eschoo, a California Democrat and the ranking member of the committee, urged providers to take responsibility for compliance themselves.
"Don't fall into the CMS enforcement lane. Do it yourselves. You've had time," Ms. Eshoo said.
Chris Severn, CEO of Turquoise Health, told the committee enforcement has lagged, and hospitals need clear, enforced guidelines for data formats.
Mr. Severn said the "sudden infusion" of billions of prices means the healthcare system needs time to adjust.
"The initial setup time for data ingestion, software development and consumer adoption explains much of the gap in perception of the optimism felt by startups like Turquoise and the skepticism in the press," Mr. Severn said.
Matthew Forge, CEO of Pullman (Wash.) Regional Hospital, said his hospital is compliant with price transparency rules, but rural hospitals can face challenges providing meaningful and usable data to patients.
Additionally, payer contracts and regulations are changing every year, and hospitals and health systems are managing competing priorities.
"We have to recruit physicians, we have to manage healthcare needs in our community. All these things come up against ensuring we have great price transparency," Mr. Forge said. "While it's one piece, it's part of a greater puzzle."