Report shows area hospitals not following transparency law

Irina Baranova

TAMPA BAY, Fla — For so many people, the cost of health care is a choice between going to the doctor or paying your bills to survive. That’s why the non-profit and non-partisan organization, PatientRightsAdvocate.org, relentlessly pushed for the Hospital Price Transparency Law.

The push was successful and it was enacted on January 1st, 2021.

Cynthia Fisher is the founder of the organization and said the law gives consumers the opportunity to price shop before they enter a hospital or doctor’s office to know the exact price they will pay for a service.

“Oftentimes, hospital bills come weeks or months later and they don’t match the patient’s experience in the hospital or the number of doctors they have seen,” Fisher said.

Fisher and her team of researchers reviewed one thousand hospitals across the country at random to identify whether they were complying one year after the bill had been made into a law.

“We have looked at the Florida hospitals thus far and sadly I can say there is not much improvement for compliance even though hospitals have had plenty of time,” Fisher said.

In its 60-plus page report, researchers found of the one thousand random hospitals selected in the country only 14.3% were in compliance. The report said the comparisons were conducted between December 7th, 2021 to February 7th, 2022. In the Bay Area, 40 hospitals made the list.

“At this point, it seems intentional because so many hospitals have put files online they’re just not filling in the data field to be compliant so you can find the price,” Fisher said.

Researchers rated hospitals in eleven different categories that include: complete standard charge file, codes, gross charge, discounted cash price, negotiated minimum and maximum along with negotiated rates, all payers and plans, 300 shoppable list, which is a list that should show consumers how much standard procedures like colonoscopies cost, price estimate tool and PET provides cash price.

“Without this data unleashed it is hurdles and information being blocked by these hospitals to prevent patients from seeing and being able to shop,” Fisher said.

ABC Action News contacted the hospitals in the review and each one said they are in compliance with the transparency rule according to the Centers for Medicaid and Medicare, or CMS. It’s the agency that keeps records of which hospitals are in compliance.

ABC Action News contacted CMS to get an accurate number and report of how many hospitals had been cited for non-compliance. According to a representative with CMS:

“As of early February 2022, CMS has issued approximately 342 warning notices to hospitals that have been determined by comprehensive review to be out of compliance with the Hospital Price Transparency regulations. CMS has also issued 124 corrective action plan requests to hospitals that previously received warning notices but have not yet corrected deficiencies, and 77 hospitals have received case closure notices after having addressed previous citations. To date, each hospital that has come under compliance review has resolved its deficiencies or is in the process of doing so. Therefore, it has not been necessary for CMS to issue any penalties.”

CMS

CMS went on to say that they do not release the name of the hospital that is not in compliance unless a monetary penalty has been given. They said their reasoning behind that is, “releasing this information prematurely could identify hospitals that have already taken corrective actions and come into compliance after issuance of a warning notice, given the relationship in the timing of our reviews and the hospitals being at various stages addressing compliance requests.”

Fines can range anywhere from $300 to $5,500 dollars a day.

In the meantime, Fisher said the best course of action consumers can take is to ask questions when seeking out medical services.

“Compare it to a fair market price and if you have been overcharged stand up for your rights. Don’t pay the bill unless you get information from that hospital first on what the actual prices are,” Fisher said.

The following Tampa Bay area hospitals made the non-compliance list according to PatientRightsAdvocate.org’s report:

AdventHealth Carrolwood
AdventHealth Connerton
AdventHealth Dade City
AdventHealth Heart of Florida
AdventHealth North Pinellas
AdventHealth Tampa
AdventHealth Wauchula
AdventHealth Wesley Chapel
AdventHealth Zephyrhills

Advent Health responded to our inquiries saying:

“AdventHealth is committed to price transparency and providing information to consumers that will help them make informed decisions before receiving elective services. The information provided by the organization you’ve referenced appears to be outdated or inaccurate. We believe the hospitals you are inquiring about are compliant with the CMS Price Transparency Rules.”

AdventHealth

Bartow Regional Medical Center
Baycare Alliant Hospital
Mease Dunedin Hospital
Morton Plant Hospital
South Florida Baptist Hospital
Winter Haven Hospital

Baycare Health System responded:

BayCare is continuing to work on posting information with regard to the requirements via the Federal Pricing Transparency Rule.

All BayCare affected facilities are listed in the pricing estimator located on BayCare’s website, and the services available for self-estimate include the 300 shoppables for each facility. These estimates can be run as a self-pay estimate, or the estimate can be customized to each person’s individual insurance information as appropriate.

In addition, information continues to be updated regarding the standard charges and negotiated rates for each hospital. This updated format and information has been posted for Bartow Regional Medical, Winter Haven Hospital, South Florida Baptist, and Morton Plant hospitals. As this is a very labor-intensive process, BayCare continues to work on additional data publication for the remaining facilities.

Patients and consumers are encouraged to reach out to BayCare’s Central Pricing Office (CPO) at 813-852-3116 for a customized estimate for services at our hospitals if they have any questions or concerns regarding potential out-of-pocket costs for hospital services.”

BayCare

Bayfront Health Brooksville
Bayfront Health Seven Rivers
Bayfront Health Spring Hill

Bayfront Health responded:

“Pricing transparency information which includes 7,600 posted services with negotiated rates for 20 payers can be found on our website at braverahealth.com. Our hospital has worked diligently to ensure information posted on our website conforms with federal requirements, and CMS has not indicated the information is non-compliant. Patients may receive more detailed information from our patient access team who is available to help them understand their health insurance benefits and provide a personalized estimate.”

Bayfront Health

Blake Medical Center

“The regulations require hospitals to post a shoppable, consumer-friendly list of services or a price estimator tool, and provide a machine-readable file containing five types of “standard charges.” Over the last year, we have worked diligently and have completed our implementation of these requirements. Our hospital website has a consumer-friendly Patient Payment Estimator tool that provides relevant information to help patients understand what their out-of-pocket costs may be for hospital care, including those that are uninsured. In addition, we have posted contracted rates with applicable insurers using one of the machine-readable file formats listed in the regulations to provide the five types of “standard charges.”

Blake Medical Center

DeSoto Memorial Hospital

“As stated last year, we are compliant with the requirements for price transparency on our website. It was available on our website last year when ABC aired that we were non-compliant and it remains on our website now. We have passed the CMS review on the matter and therefore have no changes that need to be made.”

Desoto Memorial Hospital

Doctors Hospital of Sarasota
HCA Florida Brandon Hospital
HCA Florida South Tampa Hospital
HCA Florida West Tampa Hospital
Largo Medical Center
Largo Medical Center
Oak Hill Hospital
Palms of Pasadena Hospital

HCA response:

“The federal regulations require hospitals to post a shoppable, consumer-friendly list of services or a price estimator tool, and provide a machine-readable file containing five types of “standard charges.” Over the last year, we have worked diligently and have completed our implementation of these requirements. Our hospital websites have a consumer-friendly Patient Payment Estimator tool that provides relevant information to help patients understand what their out-of-pocket costs may be for hospital care, including those that are uninsured. In addition, we have posted contracted rates with third party payers using one of the machine-readable file formats listed in the regulations to provide the five types of “standard charges.”

HCA

Encompass Health Rehabilitation Hospital of Largo
Encompass Health Rehabilitation Hospital of Sarasota

Encompass response:

“Encompass Health is dedicated to providing high quality, affordable care to our patients, and we support price transparency. The Encompass Health hospitals in Largo and Sarasota are in compliance with CMS regulations regarding hospital price transparency, and CMS has not indicated otherwise.

CMS has issued approximately 335 warning notices to hospitals it determined to be out of compliance with Hospital Price Transparency regulations. None of Encompass Health’s inpatient rehabilitation hospitals received one of these notices.”

Encompass

Lake City Medical Center

“It is important to note that sometimes websites can be delayed in posting information. We have been focused on pricing transparency for many years because we believe it’s important for patients to be able to make informed choices about their healthcare and understand their financial obligations. Lake City Medical Center has been providing pricing estimates and information about the billing process online since 2007, and we are complying with the regulation. For more information on Lake City Medical Center’s pricing transparency, click here.”

Lake City Medical Center

Lakeland Regional Health

“Lakeland Regional Health recently received correspondence from the Centers for Medicare and Medicaid Services (CMS) indicating that we are compliant with all Hospital Price Transparency regulatory requirements. We are committed to providing price transparency for our patients and families and offer a Price Transparency page on our website where people can find more information.”

Lakeland Regional Health

Manatee Memorial Hospital – Waiting on reply.

Northside Hospital – Waiting on reply.

Sarasota Memorial Hospital

“Sarasota Memorial Hospital is in full compliance with the new Centers for Medicare & Medicaid Services (CMS) price transparency rules. The information in this report is based on a review that took place last year and is no longer up-to-date.”

Sarasota Memorial Hospital

To read more about PatientRightsAdvocate.org’s report visit their website.


https://www.abcactionnews.com/news/local-news/new-report-shows-tampa-bay-hospitals-not-following-medical-bill-transparency-law

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