Utah hospitals on board with lawsuit to keep negotiated insurance rates secret

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Utah hospitals on board with lawsuit to keep negotiated insurance rates secret (Photo: KUTV FILE)

A group that represents Utah hospitals supports efforts to keep the rates that hospitals have negotiated with insurance companies secret.

National organizations, including the American Hospital Association, sued the federal government on Wednesday to keep the information private.

The Trump administration has pushed for pricing transparency in health care — in part, with a rule set to take effect in 2021 that would require hospitals to publicly post negotiated rates.

Greg Bell, president of the Utah Hospital Association, told 2News in a written statement:

“Utah’s hospitals support efforts to ensure patients have the information they need to make informed healthcare decisions. Determining out-of-pocket cost for care is a significant part of this process. However, UHA agrees with the American Hospital Association’s view that the CMS recent rule is a missed opportunity to help hospitals give patients important information. The side effects of this rule are also worrisome. Instead of helping patients know their out-of-pocket costs, the rule will most likely lead to increased confusion for consumers and accelerate anticompetitive behavior from commercial health insurers.”

Derek Monson, vice president of policy at the conservative think tank Sutherland Institute, said publishing the negotiated rates is a first step toward driving down the cost of health care.

“We think a lot of this is a symptom of a real problem that families face of being committed to paying large medical bills before they have a chance to see how big they’re going to be,” Monson said.

He said at the local, state and federal levels, people are pushing for more transparent pricing information.

“The plaintiffs may or may not win in their lawsuit,” Monson said, “but we think it’s going to be a hard thing to argue to the public, at least, that there’s a constitutional right to keep them in the dark about the cost of their care.”

Dave Moody of Highland said he was shocked when he got a bill for an MRI on his knee. The bill from a Utah hospital system was twice the national average, and hospital officials refused to budge on the price.

“You go in and get shocked after with prices,” Moody said, “and I think that’s absolutely wrong.”

A spokesman for Intermountain Healthcare, which is a member of one of the associations suing the federal government, said the health care system was studying the lawsuit, deferring to the Utah Hospital Association.

University of Utah Health — also a member of an association involved in the lawsuit — did not share its stance but said the following in a statement:

“At University of Utah Health we are committed to providing pricing transparency to our patients. It’s one of the reasons that we’ve implemented a pricing transparency tool on our website, to provide accurate cost estimates in advance of services. In fact, we are one of three institutions nationwide to be recognized by CMS (Centers for Medicare & Medicaid Services) Administrator Seema Verma for our work in price transparency. University of Utah Health was lauded for voluntarily going beyond required guidelines to promote price transparency for our patients.”

The Shriners Hospitals for Children in Salt Lake City said:

“At the local level, we do acknowledge our awareness of the lawsuit. We will interface with our system to see how this impacts us. We are dedicated to compliance with regard to any potential regulatory outcomes.”