House Panel Considers Health Care Pricing Transparency Proposals
On Thursday, members of the House Energy and Commerce Health Subcommittee at a hearing agreed that health care providers need to be more transparent about their pricing and offer consumers more information that could help them make better medical decisions, CQ Today reports.
However, the panel did not reach a definite consensus on any of the three proposals that would facilitate such improvements, forcing Subcommittee Chair Frank Pallone (D-N.J.) to delay a decision on markup of the bills. All but one of the bills has bipartisan support but none have companion Senate bills.
- HR 4700: The bill -- sponsored by Rep. Steve Kagan (D-Wis.) without any Republican support -- would require hospitals, physicians, nurses, pharmacies, and a number of manufacturers and vendors to disclose publicly the prices they would charge patients. The HHS secretary would levy a fine on providers and vendors that fail to comply with the requirement (Ethridge, CQ Today, 5/6).
- HR 2249: Cosponsored by Texas Reps. Gene Green (D) and Michael Burgess (R), the bill calls for transparency in hospital charges (Pecquet, "Blog Briefing Room," The Hill, 5/6). The legislation also would expand reporting requirements to all 50 states and require insurance companies to disclose out-of-pocket cost estimates for a number of medical procedures (Reichard, CQ HealthBeat, 5/6).
- HR 4803: The proposal, sponsored by House Energy and Commerce Committee ranking member Rep. Joe Barton (R-Texas) with broad Democratic support, would cover ambulatory surgical centers serving patients who are not hospitalized after their operation ("Blog Briefing Room," The Hill, 5/6). It would require the centers, as well as hospitals and private and public health insurers, to disclose to their patients and customers information about the costs for services they provide and the items and services that they cover, respectively (CQ Today, 5/6).
According to the "Blog Briefing Room," Kagan's bill, which has 54 Democratic co-sponsors, has drawn criticism from the industry for being too broad and requiring information about providers' pricing negotiations with insurers, which health insurers have said could lead to higher prices ("Blog Briefing Room," The Hill, 5/6).
Mixed Testimony From Experts
Several health policy and law experts who testified before the panel expressed mixed opinions about whether legislation would result in lower health care costs, CongressDaily reports.
Mike Cowie -- an antitrust law expert who previously worked with the Federal Trade Commission -- said that making prices more available "makes it easier for collusions" (McCarthy, CongressDaily, 5/7). "If a company knows how its rivals set prices, that company may raise its own prices to meet those of its competitor," Cowie said (CQ Today, 5/6). He added that Kagan's bill "in particular would conflict with established antitrust principles designed to prevent collusion" (CQ HealthBeat, 5/6).
However, Regina Herzlinger of the Harvard Business School said that pricing transparency is "the No. 1 change Americans wanted from the government" in the health reform legislation, adding, "Transparency could help insurers to better control costs by constructing narrow networks of the best value doctors and hospitals."
Herzlinger recommended a mandatory national reporting strategy in place of a state-only approach because "state transparency agencies that limit information to local providers may prevent insurers from creating multistate networks of best-value providers." She noted, "Absent governmental oversight, we have little hope that health care will significantly improve transparency" (CQ HealthBeat, 5/6).
Pallone Noncommittal About Bills, Markup Schedule
According to CQ Today, none of the three bills stood out as a clear favorite among the panel, and Pallone declined to endorse any of the bills (CQ Today, 5/6).
He also declined to say definitively if the committee would begin a markup of the legislation before the summer recess in August, CongressDaily reports (CongressDaily, 5/6).This is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.