New CMS rule will confuse patients, groups say

December 10, 2019
Christine Blank

Hospitals sue over drug price disclosure rule.

Four hospital and health system organizations sued the federal government last week, saying they should not have to disclose the rates they pay for medications negotiated between hospitals and insurers.

The complaint, brought against HHS by the American Hospital Association, the Association of American Medical Colleges, the Children’s Hospital Association, and the Federation of American Hospitals, challenges a new rule from the Centers for Medicare & Medicaid Services (CMS).

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“The legal challenge became necessary after the administration finalized the rule, despite offers from the hospital community to work together to find alternative solutions that would allow hospitals to provide every patient with meaningful cost-sharing information, including most importantly their out-of-pocket costs,” the groups say in a joint statement.

HHS does not have the statutory authority to enforce a provision that mandates public disclosure of individually negotiated rates between commercial health insurers and hospitals, the organizations added.

Related: Physicians’ Group Wants Pbm Drug Price Transparency

“Instead of giving patients relevant information about costs, this rule will lead to widespread confusion and even more consolidation in the commercial health insurance industry. We stand ready to work with CMS and other stakeholders to advance real solutions for patients,” says Rick Pollack, president and CEO of the AHA, in the statement.

"Children’s hospitals care for children with the most complex conditions, and the majority of our patients are covered by Medicaid. We are concerned our patient families may confuse these commercial rate disclosures and not seek essential care for their children," says Mark Wietecha, president and CEO of CHA.

Read more: The Impact Of Medicare Part D Proposals On Drug Pricing

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