Monmouth Times

Woodbridge, NJ – Congressman Frank Pallone, Jr. (NJ-06) provided an update on June 12 on bipartisan legislation that will help consumers compare and better understand the cost of health care services across different hospitals. Pallone recently introduced the Promoting Access to Treatments and Increasing Extremely Needed Transparency Act or the PATIENT Act, which strengthens transparency requirements for both hospitals and insurers by requiring them to display price information in a format that consumers can easily understand.

The PATIENT Act passed out of the Energy and Commerce Committee last month with unanimous bipartisan support. The bill requires hospitals to make public all standard charges for items and services and to display charges for the hospital’s 300 most “shoppable” services in a consumer-friendly format. Additionally, the bill requires insurers to make public their negotiated in-network provider rates for all items and services, billed charges for out-of-network items and services, and personalized cost-sharing information. 

Pallone’s legislation also increases transparency of pharmacy benefit managers (PBMs) to help employers and consumers better understand drug price information and lower health care costs. The opaque contracts of pharmacy benefit managers make it difficult for employers and plan sponsors to understand drivers of cost and negotiate savings. The legislation requires PBMs to annually provide employers with detailed data on prescription drug spending, including the acquisition cost of drugs, total out-of-pocket spending, and additional information.    

“Patients deserve greater transparency in the prices they pay for health care and prescription drugs. Unfortunately, consumers are not able to easily obtain price information in advance, and sometimes the information that is available is inaccurate and misleading, making it difficult to determine the true value of the care. The lack of transparency makes it difficult for both consumers and employers to make informed decisions,” Pallone said. “The PATIENT Act puts patients first by bringing more transparency to health care and prescription drug costs. The unanimous vote out of my Committee last month is an important step in making health care more affordable and accessible for consumers. I’m hopeful it will receive a vote of the full House soon.”

“Every bill is a surprise bill when patients don’t have access to upfront prices. Even after the Hospital Price Transparency Rule went into effect more than two years ago, the majority of hospitals continue to take advantage of people by hiding prices. Thanks to the leadership of Congressman Pallone, Congress now has the opportunity to stand up for all Americans by passing the bipartisan PATIENT Act,” said Cynthia Fisher, Founder & Chairman of Patient Rights Advocate. “This legislation will ensure patients have actual upfront prices and end hospital extortion of patients through robust enforcement and substantial civil monetary fines. I am grateful to Congressman Pallone and his colleagues for their work to lower costs and improve the quality of care for New Jerseyans and people across the country.”

“Not having access to affordable and equitable health care is not only an economic issue, it’s a humanitarian one. As a country, it’s simply unconscionable that we are dependent on a health care system that is stacked against us with hidden prices and a total lack of accountability for egregious corporate profits. Without real transparency, we are allowing the corporate greed of hospitals and insurance company executives to perpetuate a system void of competition and decency, but overflowing with fear, distrust, and patients facing overcharges, medical debt and even bankruptcy,” said Kevin Morra, a Founder of the non-profit advocacy movement, Power to the Patients. “We profoundly appreciate and greatly admire the strength of leadership demonstrated by Congressman Pallone for his tenacious work toward health care price transparency as Ranking Member of the House Energy & Commerce Committee on behalf of patients, families, employers, unions, municipalities, and communities across New Jersey and the entire country.”

“We stand with Congressman Pallone in his fight for transparency in health care pricing. Hospitals and insurers should not be allowed to bully the consumer into paying exorbitant fees for basic health care,” said Kevin Brown, New Jersey State Director of 32BJ SEIU. “Transparency is the first step toward fighting the health inequities that disproportionately impact Black, Brown and immigrant communities statewide. The price of health care has risen exponentially in recent years and giving the consumer more information is the first step toward fighting back.”

“Many New Jersey families still struggle with affording health care and life-saving prescription drugs, and patients frequently face significant price discrepancies. Legislation to enhance health care transparency, such as Congressman Pallone’s PATIENT Act, helps empower consumers, fosters competition, and leads to a clearer understanding of the factors that influence health care costs,” said Laura Waddell, Health Care Program Director, New Jersey Citizen Action. “Our goal should be to further strengthen transparency and help improve affordability of coverage and this is an important step in that direction.”

According to an analysis by the New York Times, a single hospital can have up to a 300 percent price difference for the same service, depending on the insurer. Another analysis by the Peterson Center and the Kaiser Family Foundation found the price of a joint replacement for knee or hip surgery varied widely across the 20 largest metropolitan areas, ranging from less than $20,000 to more than $70,000.  

Original source can be found here