Braun
In the world of the Washington politics, U.S. Sens. Mike Braun (R-Indiana) and Bernie Sanders (I-Vermont) would seem to make odd bedfellows.
But the conservative Braun and the liberal Sanders might have more in common that meets the eye, with a growing list of issues they have both supported, including paid sick days for rail workers and travel reimbursements for veterans seeking health care.
Now the two are coming out with their latest shared issue: stricter price transparency standards in health care.
Braun and Sanders—along with three other senators, Chuck Grassley (R-Iowa), Tina Smith (D-Minnesota) and John Hickenlooper (D-Colorado)—this month introduced a bill aiming to strengthen health care price transparency.
Since 2019, hospitals have been required to post all their full-price charges on their website to help patients and consumers understand how much they might get billed. But because health plans, insurers and pharmacy benefits managers still negotiate prices behind the scenes, resulting in different prices for different patients at different locations, it’s still hard for consumers to predict their out-of-pocket costs.
So now Braun, Sanders and the others are pushing what they call the Health Care Price Transparency Act 2.0, which will require all negotiated rates and cash prices between plans and providers to be accessible.
It’s time for Congress to pull back the curtain, they say.
“It’s wrong that the same procedure can be 20 times more expensive in one hospital than in another, and there’s no other industry where consumers are in the dark on the price of what they are buying,” Braun said in a Jan. 10 press release.
He added: “The Health Care Price Transparency Act 2.0 will pull the curtain back and put the power back in the hands of the American people, introducing real market competition into the health care industry and bringing down prices.”
Braun has authored transparency legislation in prior congresses, including bills that would prevent so-called “surprise billing” by out-of-network providers.
Specifically, the new bill would:
- Require machine-readable files of all negotiated rates and cash prices between plans and providers, not estimates.
- Expand price transparency requirements to clinical diagnostic labs, imaging centers and ambulatory surgical centers.
- Require pricing data standards, including all billing codes for services.
- Require actual prices for 300 shoppable services, with all services by 2025.
- Increase maximum annual penalties to $10 million.
- Provide group health plans with the right to access, audit and review claims encounter data.
The bill seems to have a good chance of getting a hearing and advancing to the Senate floor. The chair of the Senate Health, Education, Labor and Pensions Committee is Sanders, a democratic socialist.
“We applaud Senators Braun and Sanders for their bipartisan leadership on the Health care Price Transparency Act 2.0, which will transform our health care system by ensuring all Americans have access to actual, upfront prices,” Cynthia Fisher, founder and chair of Patient Rights Advocate, said in written remarks.
She added: “For too long health care consumers, including workers, employers, and unions, have been subject to non-binding estimates and overcharged medical bills because hospitals and health insurers take advantage of an opaque system that hides the true cost of care and coverage. Systemwide health care price transparency will improve health outcomes and lower the cost of coverage and care for all Americans. We encourage all senators to support this bill and stand up for patients against industry profiteering.”
By John Russell of Indianapolis Business Journal
