OKLAHOMA CITY (KFOR) – News 4 is looking out for you when it comes to knowing the cost of services when you go to the hospital.
Two years ago, a national law went into effect requiring hospitals provide clear, accessible pricing information online for patients, but a new study shows less than 10% of Oklahoma hospitals aren’t in compliance.
The law is designed so patients know what they can expect before going into surgery – and possibly – debt.
But one group claims only 3 of 36 hospitals in Oklahoma are following it.
“Ultimately the goal here is to allow anybody to see where they can get an MRI for $300 versus over paying $3,000 for that MRI,” said Cynthia Fisher with PatientRightsAdvocate.org.
Fisher says hospitals are required to post forms that will allow search engines like Google to create mobile shopping apps with price comparisons.
According to The Centers for Medicare & Medicaid Services’ website, hospitals are required to provide clear pricing information online in two ways:
- As a comprehensive machine-readable file with all items and services
- In a display of shoppable services in a consumer-friendly format
Fisher’s group claims OU Health, Saint Mary’s Regional Medical Center and Wagoner Community Hospital are in compliance.
Fisher sent News 4 examples of lists in compliance and ones they claim are not in compliance, for reasons like omitting discounted cash prices and negotiated rates.
We reached out to the Oklahoma Hospital Association to get their take.
In a statement – President Patti Davis said in part:
“… The true arbiter of compliance is the federal government, and we urge consumers to be cautious of assessments done by external groups that may or may not be consistent with the rule’s criteria.”
Only two hospitals across the US have been fined since this law was enacted.
“Just because they haven’t been fined doesn’t mean that their file is usable for creating competition and empowering consumer choice,” Fisher said.
The Centers for Medicare & Medicaid Services tells News 4, as of this month it has issued nearly 500 warning notices to American hospitals that have been determined to be out of compliance.
In a statement CMS says in part “To-date, every other hospital that has come under compliance review has resolved its deficiencies, or is in the process of doing so.”
We reached out to metro hospital systems listed in the report as being not in compliance.
All of them – Integris, Mercy, SSM and Norman Regional – claim they are in compliance and provided a link to more information.
You can find that and their full statements below:
INTEGRIS Health is in compliance with the law. We have practiced price transparency since 2006 by providing out-of-pocket charge estimates to patients through our Consumer Priceline at 405-713-4500. Financial counselors are also available by phone or email. Additionally, prices for many common procedures can be found on-line at https://integrisok.com/patient-information/pricing.
A charge master is a list of standard prices established by hospitals for any individual services and supplies provided by the hospitals. All patients receive the same gross charge for items and services, but negotiated charges change based on agreements in place with insurance companies. Charges do not include available discounts for individual insurance coverage or if a person meets the financial assistance criteria needed. The charge master also does not include fees from the surgeon, anesthesiologist or other professional services that are billed separately. For these reasons, it is best to consult with your insurance provider to get the most accurate out-of-pocket costs.
Norman Regional is compliant with the law and CMS regulations to provide clear, accessible pricing information online.
Here is the link to our where visitors can download the pricing information for our items and services. https://www.normanregional.com/request-an-estimate
Also attached is a screenshot of where patients can find the published list.
We also offer additional resources and contact information for patients who need extra assistance, both over the phone and through email.
In addition to the contact information here’s a link to our patient estimator tool: https://normanregional.patientsimple.com
SSM HEALTH ST. ANTHONY:
“SSM Health is in full compliance with the price transparency rule for all of our hospitals in Oklahoma and is committed to empowering patients to make informed decisions about their care. This includes helping patients understand the cost of their care, as well as financial assistance that may be available. We offer an interactive price transparency tool on our website to learn more about the costs associated with various services. CMS requires 70 procedures that must be included. Then, under price transparency requirements, the hospital chooses the remaining procedures commonly provided by the hospital to achieve a minimum of 300 services displayed. SSM Health St. Anthony Hospital in Oklahoma City includes a total of 329 procedures in this tool. For questions about pricing or using the tool, we also invite patients to call our price transparency team at 844-989-6292.”
Please click here to visit the tool online.
CMS determines hospitals’ compliance with these regulations, and while political groups continue to ask for new rules and regulation, they don’t set the requirements. We stand by our transparency efforts, which are supported by the fact we acted quickly to correct a single request raised by CMS in 2021. We would do the same if CMS had other concerns.
Patients are always welcome to call 855-420-7900, the phone number listed on each page of Mercy’s price transparency website, for help with a cost estimation.