Advocates criticize unfunded transparency mandate on imaging providers in recently passed legislation
Industry advocates are criticizing one key piece of a recently passed legislation, which would require radiology providers to disclose prices for imaging services.
The U.S. House passed the Lower Costs, More Transparency Act on Dec. 11 in a 320 to 71 vote. It would require imaging providers, hospitals, ambulatory surgery centers and others to publicly list prices they charge patients, building on previous Trump administration transparency rules.
Section 103 of the bill stipulates that providers of certain “shoppable” imaging services must disclose the discounted cash price. Plus, “if required” by HHS, it also would mandate the disclosure of deidentified minimum and maximum payer-specific negotiated charges for services.
The American Society of Nuclear Cardiology, however, noted that these provisions would be “duplicative of payer requirements, imposing an unnecessary administrative burden on physician practices.”
“We firmly believe it should be the responsibility of health plans and issuers to provide price information to their enrollees,” Mouaz Al-Mallah, MD, president of the ASNC, said in a Dec. 11 letter to leaders of the House. “Consumers must be able to compare prices among in-network providers, which is most easily facilitated by the health plan or issuer. It is unclear how deidentified minimum and maximum payer-specific negotiated charges for specific services, which could include pricing for multiple payers and plans, made available by the imaging provider or practice will facilitate consumer decision-making and could, instead, lead to consumer confusion.”
Al-Mallah noted that most physician practices already share cash price information with patients, when requested. Any added requirements in this regard, he wrote, “should be accompanied with the least amount of administrative burden possible on physician practices.” Section 103 is likely to affect “the vast majority” of physicians who provide imaging services in an office setting.
“We respectfully request that Congress not create the potential for unnecessary administrative burden on physician practices,” he wrote.
Tim Ninke, CEO of vendor eInformatics, recently messaged Radiology Business about the provision, expressing concern about the burden it could impose on radiologists.
“This bill, while well intended, appears to be another unfunded federal mandate placed on imaging providers,” he said by email. “Congress should be incentivizing the outcomes they desire instead of mandating/punishing/fining. It would generate more willing and much faster adoption, as healthcare providers (especially imaging providers) are looking for ways to recoup losses from falling reimbursement, inflation, and labor shortages.”
The U.S. Senate still needs to consider the bill before it becomes law.
Marty Stempniak has covered healthcare since 2012, with his byline appearing in the American Hospital Association's member magazine, Modern Healthcare and McKnight's. Prior to that, he wrote about village government and local business for his hometown newspaper in Oak Park, Illinois. He won a Peter Lisagor and Gold EXCEL awards in 2017 for his coverage of the opioid epidemic.