Most people using hospital services must sign a form indicating that they will pay whatever their health insurance doesn’t. Federal transparency rules can help defend us against the consequence of that signature.
Federal price transparency rules require hospitals to post all negotiated rates, including cash prices for the uninsured, every single commercial insurance plan that they’ve contracted with, and even rates for government programs such as Medicare, Medicaid, Tricare and the Veterans Administration.
Those rules require hospitals to display:
- Pricing in a prominent place on the hospital website—if it’s hard to find, the hospital is out of compliance.
- A machine-readable file (usually an .xls or .crv file) with this information. Interactive tools that only show you your plan’s price aren’t good enough.
- Negotiated charges with EVERY insurance plan or program—if the hospital is “in-network” but you don’t see your plan listed in the columns of the posted price chart, as well as every single service they provide in the rows, the hospital is out of compliance.
Ignoring these rules is a bullying tactic to make you think you’re contractually bound to pay whatever the hospital charges. Unless the hospital makes its pricing accessible, the form you signed is what courts would find an “open price” contract, meaning a seller (hospital) may only expect the buyer (you, the patient) to pay if a court would find the price to be a fair market rate.
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