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PRA Releases New Report: Insurance Pricing Files Reveal that Hospitals are Hiding Prices

Today, PatientRightsAdvocate.org released its first Transparency in Coverage (TiC) report. This report examined newly available data from health insurance companies, which are required to disclose the previously hidden prices they've negotiated to pay hospitals and providers. The public posting of these data files is mandated by the Transparency in Coverage rule, which took effect on July 1, 2022.

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Analysis Finds Bon Secours Hospitals are Not Compliant with the Hospital Price Transparency Rule
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Analysis Finds Bon Secours Hospitals are Not Compliant with the Hospital Price Transparency Rule

The New York Times recently published an investigation revealing the Bon Secours hospital system is profiting off its poor patients by hollowing out Richmond Community Hospital, which primarily serves the indigent, and using this hospital to bolster its systemwide 340B revenues. PRA finds that Bon Secours is also profiteering off all its healthcare consumers, including employers and unions, by hiding its actual prices.

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NJ.com features op-ed co-authored by Cynthia Fisher calling for the need for price transparency in New Jersey
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NJ.com features op-ed co-authored by Cynthia Fisher calling for the need for price transparency in New Jersey

Cynthia Fisher, PatientRightsAdvocate.org founder and chairman, joined Kevin Lyons, the director of Member Benefits at the New Jersey State Policemen’s Benevolent Association, and Christin Deacon, the former director of Health Benefits Operations and Policy and Planning for New Jersey, on an op-ed calling for the need for price transparency in New Jersey after the State Health Benefits Commission voted to raise health premiums for hundreds of thousands of state and local workers by approximately 20%.

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PRA Submits 2023 OPPS Comments with Families USA
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PRA Submits 2023 OPPS Comments with Families USA

PRA and Families USA submitted public comments on the proposed 2023 CMS OPPS rule. CMS used the OPPS rule to promulgate the Hospital Price Transparency Rule, and has the opportunity to improve upon it this year through this Proposed Rule.

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Transparency in coverage rule now in effect
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Transparency in coverage rule now in effect

As of July 1, 2022, The Transparency in Coverage rule, issued by the Centers for Medicare and Medicaid Services (CMS), requires insurance companies and employer plans, like hospitals to publish their actual prices online for the services and goods they provide.

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PRA Calls on HCA Hospitals to Follow Transparency Laws
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PRA Calls on HCA Hospitals to Follow Transparency Laws

PatientRightsAdvocate.org sent a letter to HCA Healthcare ahead of their annual meeting alerting leaders that zero of their 188 hospitals reviewed are complying with price transparency rules, encouraging them to comply and provide transparent prices. The letter also included PRA’s semi-annual report showing that only 14.3% of hospitals nationally are complying with the 2021 Hospital Price Transparency laws.

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Colorado Legislation Protects Patients from Financial Ruin
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Colorado Legislation Protects Patients from Financial Ruin

Colorado is currently considering legislation to protect patients from financial ruin. HB1285 forbids hospitals from sending consumers' bills to collections if they aren't complying with federal price transparency law. The legislation adheres to a fundamental moral principle: You shouldn't face bankruptcy for bills you never agreed to. It is sponsored by Republican and Democrat leadership.

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PRA Sends Letter to Congress Requesting Greater Enforcement of Price Transparency
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PRA Sends Letter to Congress Requesting Greater Enforcement of Price Transparency

PatientRightsAdvocate.org sent a letter to U.S. Congress requesting greater enforcement of healthcare price transparency. The letter cites PRA’s recent report showing that only 14.3 percent of hospitals are complying with price transparency law. It also highlights new polling conducted by John Della Volpe and SocialSphere finding that healthcare price transparency is supported by an overwhelming bipartisan majority of around 90 percent of Americans.

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