Several groups sue to overturn healthcare price transparency rule

August 27, 2021 – The U.S. Chamber of Commerce and the Pharmaceutical Care Management Association have filed lawsuits against HHS and other federal agencies in federal courts in Tyler, Texas, and the District of Columbia in order to block parts of a federal rule that requires insurers and employers to disclose prices they pay for healthcare services and drugs.

The groups claim certain provisions of the rule go beyond federal authority and could raise healthcare costs.

The rule they are challenging requires that starting in 2022 health plans, including those offered by employers that are self-insured, publicly disclose the rates they pay to hospitals and other healthcare providers.

The rule also requires price disclosures for drugs, including a measure called the “historical net price” that factors in the effects of rebates, fees and discounts. The data is supposed to be made available in a format that can be read by computers.

The rule was instituted by the Trump administration and President Biden also signaled support for healthcare pricing transparency in an executive order released in July.

The Trump administration, when it issued the rule, said disclosing healthcare prices could help rein in the cost of healthcare because they might find lower prices online for services that are shoppable.

According to The Wall Street Journal, some economists have said the effect of revealing previously secret healthcare rates is not yet clear but is likely to vary depending on the situation and the players involved in negotiating the prices.

Researchers have suggested that the wide range of prices is likely to narrow because hospitals and other providers who learn they’re receiving the lowest rates will likely push to raise them, while on the other end, insurers who find they are paying the most will likely seek greater discounts so that the prices they pay are closer to their rivals’ rates.

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