PatientRightsAdvocate.org Applauds Marshall-Hickenlooper "Patients Deserve Prices” Bill
Today, PatientRightsAdvocate.org (PRA) applauded the introduction of S.2355, the Patients Deserve Price Tags Act. to codify federal hospital and insurer price transparency rules. The bill was introduced by Senator Roger Marshall (R-KS), a member of the Senate Health Education Labor and Pensions (HELP) Committee, and Senator John Hickenlooper (D-CO), HELP Committee Ranking Member.
"We applaud Senators Roger Marshall and John Hickenlooper for their strong, bipartisan leadership on the ‘Patients Deserve Price Tags Act,’” said PRA Founder and Chairman Cynthia A. Fisher. “With actual, upfront, and accountable prices, patients will be able to shop for the best care with protection from rampant overcharges hiding in the shadows,” “We urge all senators to support this bill and pass it without delay to protect America's patients."
Price transparency is supported by 96% of Americans, who agree they “deserve to know the price of their healthcare before they receive it.” Additionally, 9 out of 10 Americans view upfront prices as a matter of fairness.
"Healthcare is the only industry where consumers are expected to make binding financial commitments without knowing how much they will owe,” said Hoover, Alabama patient Kerry Schrader. “Last year, I diligently sought an upfront price for a biopsy, but without any answers, moved forward with the simple but necessary outpatient procedure. It resulted in a bill of over $28,000 for a procedure performed in my doctor's office while I was fully awake and did not even require an IV or monitors. Though I have insurance, which did reduce the amount owed, my remaining medical debt was sent to collections, forever changing the way I approach care. I have canceled a colonoscopy because I cannot get a firm price. The ‘Patients Deserve Price Tags Act’ will help Americans like me have financial certainty and hold hospitals accountable."
Summary of Key Bill Provisions:
Unprecedented transparency requirements for all health plan middlemen who add unnecessary costs to health care.
Employer and union group health plan’s Third Party Administrators (TPA) would be required to provide detailed information to the plan on claims and financial transactions of their subsidiaries and subcontractors, such Pharmacy Benefit Managers (PBMs).
Strengthens and codifies existing hospital price transparency rules to require dollars-and-cents prices, not estimates, expands them to other care settings, and imposes greater penalties for noncompliance.
Codifies and strengthen existing Transparency in Coverage (TiC) provisions, including a requirement that a plan executive attest that all prices are “accurate and complete.”
Requires a detailed explanation of benefits by all commercial healthcare plans, as well as itemized bills by providers so patients no longer have to sign a blank check.
About PatientRightsAdvocate.org:
PatientRightsAdvocate.org (PRA) is a leading national healthcare price transparency organization dedicated to ushering in systemwide transparency through advocacy, testimony, media, legal research, and grassroots campaigns. PRA believes that the availability and visibility of actual, upfront healthcare prices will greatly lower costs for patients and employers through a functional, competitive healthcare marketplace.