Price Shopping Medical Services Online?

A new law went into effect on January 1st, requiring that all hospitals publish an online list of the procedures they offer and their prices. This is a huge step in the very secretive and protectionist health insurance industry. It also means that not only should you be shopping online to make sure you’re getting the best possible price on that sequined Mardi Gras jumper, but should also be shopping around for your non-emergency medical needs.

            Also called a “chargemaster list,” federal law now requires that all hospitals post a list of procedures and the prices for those procedures on their website for patients to review. In reviewing various hospitals lists, hospitals have assigned their respective lists a variety of names, including “Billing Estimator”, “Procedure Bills”, etc. Most of the time the easiest way to find the list is to go the billing section of the website.

             Pursuant to the Affordable Care Act all hospitals were required to release price lists, but the CMS has expanded that duty, which they have explained as follows:

All hospitals operating within the United States are required to establish (and update) and make publica list of their standard charges for all items and services provided by the hospital. Under current guidelines, subsection (d) hospitals are additionally required to establish (and update) and make public a list of their standard charges for each diagnosis-related group established under section 1886(d)(4) of the Social Security Act.   

            Proponents of the new law hope that this first step towards transparent pricing will result in lower prices for consumers, and will drive more competition between hospitals. Proponents hope that with this information being made public,  consumers will be able to find the best possible prices for their needed procedures,  and that eventually it will lead to more standardized pricing.

             Hospitals have countered, arguing that determining the cost to a consumer is not as simple as just looking at the list. They argue that the true cost to the consumer can only be determined by also determining the amount of out of pocket costs under a given plan, and therefore the lists are unnecessary and actually confusing.

             Admittedly, forcing hospitals to disclose their prices will not immediately solve the huge variances in medical costs and billing, but it is certainly a significant first step. The more information consumers are given, the more power they have to ensure that they are getting the best possible deal from their health insurer and health care providers.    

  - Chris M. Short is an associate attorney at Kiefer & Kiefer.  

This is provided for informational purposes only and not for the purpose of providing legal advice.

Megan Kiefer