BREVARD, N.C. — A recent report found many hospitals across North Carolina are not listing prices for treatment as they should.
What You Need To Know
The hospital price transparency rule was enacted January 2021 and requires hospitals to provide clear pricing information online in a consumer-friendly format
The nonprofit Patient Rights Advocate examined 49 hospitals in North Carolina and found 67% were not in compliance with federal transparency rules on pricing
Some hospitals argued against this report and claim they are in compliance
Another report by Attorney General Josh Stein found 25 hospitals were not in compliance out of 147
Palma Cohen tries to walk every other day. She has multiple sclerosis, which is a disabling disease that impacts the nervous system. Walking helps maintain her muscle strength.
“I feel like I am stronger when I am exercising, and I try to eat right and all those things,” Cohen said.
She also likes walking because it’s free, and her illness costs her a lot of money. Every year she is supposed to get a brain and spinal MRI. She usually goes to a location in Asheville because it’s close to where she lives.
“I have spent anywhere from $1,200 to $2,700,” Cohen said.
Cohen’s insurance doesn’t cover the cost so that is what she pays out of pocket each year for the exam. She usually goes every other year because she can’t afford it. But she says that is putting her health in jeopardy. The MRIs help determine if her medication is working.
“One day the doctor looked at my MRI and said, ‘Palma this medicine is not working.’ I said, ‘what do you mean it’s not working?’ He explained to me all the new lesions that I had,” Cohen said.
In January 2021 federal rules were passed that requires hospitals to provide clear, accessible pricing online in a consumer-friendly format. Despite the new law Cohen has tried to look up MRI prices at other locations but has struggled to find them.
“They send you all over the place to try and get an estimate,” Cohen said. “I have been clicking here and not getting anything.”
According to a report by Patient Rights Advocate several hospitals in her region are not following the new law on hospital price transparency. The nonprofit patient rights advocate examined 49 hospitals across North Carolina and found that 67% were not in compliance.
“Over 100 million Americans are in medical debt, and it’s because they can’t shop and compare prices,” Power to the Patients President Marni Carey said. “Two-thirds of Americans go without care because they are afraid of the price.”
Carey says Power to the Patients is a nonprofit which educates patients on access to fair medical pricing.
“The second thing that happens when prices are transparent is that competition enters the marketplace, and those high prices tend to come down,” Carey said.
Cohen just hopes hospitals realize how this is impacting patients.
“I just wonder why, why wouldn’t you want to make it easier for the patients?,” Cohen said. “Isn’t that the whole goal? You want healthy patients, you want them to get their test and you want them to be healthy. Isn’t that the whole point of health care?”
Spectrum News 1 reached out to a few large hospitals which the report stated were not in compliance. The hospitals argued against the study, saying their hospitals were in compliance. The Centers Medicare and Medicaid Services, also known as CMS, is the group in charge of monitoring price transparency. CMS could not confirm if these hospitals were in compliance. A CMS spokesperson released the following statement:
“Status of hospitals is not publicly available until after a CMP [civil monetary penalties] has been issued. Releasing this information prematurely could identify hospitals that have already taken corrective actions and come into compliance after issuance of a warning letter, given the relationship in timing of our reviews and the hospitals being at various stages addressing compliance requests,” Centers for Medicare and Medicaid said in a statement.
As of July 2022, CMS reports it has issued about 368 warning notices to hospitals on price transparency regulation. It has also issued 188 corrective action plan requests, and 204 have received case closure notices. CMS has imposed civil monetary penalties on two hospitals not in compliance in Georgia.
A spokesperson for Atrium Health released the following statement:
“It’s unclear how this list is being derived, but it is inaccurate. It’s also worth noting the organization pitching this story lists Atrium Health Carolinas Medical Center as being compliant, with others within our system not. All of our facilities are using the exact same platform, format and methodology in presenting the required information.
"Since the beginning, Atrium Health has made compliance with the federal requirement a priority. The Centers for Medicare & Medicaid Services (CMS) is the sole authority on this requirement. It reviewed our website last year and determined the content included on our website met the necessary requirements,” Atrium Health said in a statement.