AHA Loses Latest Legal Battle Challenging Price Transparency

December 29, 2020 By: Quadax

AHA claimed requirement too burdensome; judges skeptical, rule in favor of HHS

The American Hospital Association (AHA) was hoping for intervention from the D.C. Circuit Court of Appeals as the Price Transparency rule requiring hospitals to publicize rates goes into effect Friday, January 1, 2021. The AHA filed for an emergency notion to block the rule from going into effect, citing hospitals are overwhelmed with COVID-19 vaccine distribution and record-high caseloads of COVID-19.

The three-judge panel was highly skeptical of the AHA’s claims when it heard oral arguments in October and pushed back their line of questioning. The AHA has contended the requirement is too burdensome and compiling a consumer-friendly price list is impossible.

The undoing of the case may have been when AHA's litigator told judges certain prices are "unknowable." That only provoked more questions from primarily two of the three judges who seemed baffled by the claim that prices were unknowable. Judges Merrick Garland and David Tatel launched into a lively line of questioning about the cost of X-rays.

The AHA argued that it's impossible to know the rates because in some instances a patient may require more care than was originally anticipated.

But Tatel said these arguments missed the mark. Hospitals are not required to disclose all the possible prices, instead they're required to disclose base rates that are negotiated with insurers.

As a result, Tatel affirmed the district court's grant of summary judgement in favor of Health and Human Services (HHS).

Are you prepared?

In conversations with some of our clients, we’ve learned that some hospitals aren’t completely prepared for the Price Transparency mandate. Many hospitals assumed the mandate would be postponed in light of the global pandemic and already thinly stretched resources. If you’re in this boat, you’re not alone.

Quadax can help. You can quickly deploy secure, compliant and user-friendly web pages where patients can interactively explore shoppable services and create personalized estimates with Payer Price Transparency by Quadax.

With Price Transparency you can:

  • Ensure Compliance with new payer price transparency rules
  • Rapidly Deploy organizational branding and disclaimers to your website for a seamless user experience
  • Customize shoppable services and pricing required to be displayed
  •  Enrich the patient experience with an easy-to-use, personalized pricing calculator
  • Track & Learn from patient-submitted estimate data

Check out this quick video for more information. And, let’s take on the revenue cycle together!

 

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