AG urged to stop medical-pricing-law scofflaws
Attorney General Maura Healey should “assert leadership” on behalf of consumers and motivate health care providers to comply with the state’s price-transparency law, the Pioneer Institute recommends in a report out today that found wildly varying costs for procedures and a reluctance to spell out those prices.
“They take payment seriously, and they should. But the other side of that is telling people up front what a procedure will cost. It’s disappointing and it’s unfortunate that the major players in the health care community in Massachusetts have not taken price transparency seriously. I get the impression that it’s just not a priority,” attorney Barbara Anthony, Pioneer’s senior fellow in health care policy, told the Herald.
“The state could exercise more leadership here and encourage greater compliance by licensing authorities. There’s enough authority to go around,” Anthony said.
Pioneer lists among its recommendations for change that, “The Attorney General’s Office can also assert leadership on this issue under the state’s Consumer Protection Act, Chapter 93A, which states that any violation of a state law that is designed for the protection of consumers is punishable by fines, injunctive relief, and restitution. Similarly, the Attorney General’s Office can use its powers to incent providers and payers toward a more enthusiastic embrace and utilization of price transparency.”
Using the guise of a self-paying patient with a high-deductible health insurance plan value shopping for a “very common” leftknee MRI minus dye injection, researchers approached 21 of the state’s 66 acute-care hospitals. They found that getting basic information that should be readily accessible under a 2014 law remains “a daunting and frustrating experience ... that most consumers would not persevere through.”
“Operators still did not know where to direct consumers seeking price estimates, obtaining the information involved multiple callbacks and voicemail messages, and researchers were often directed to third parties to obtain the price of the radiologist’s reading fee,” the Pioneer Institute’s 2017 follow-up to a 2015 survey states.
Anthony said what most people find shocking is the dramatically disparate out-of-pocket costs patients are being charged for the same procedure. In the greatest extreme cited, Morton Hospital and Medical Center in Taunton quoted a discounted price for self-paying patients of $637 for the knee MRI versus $6,928 for the same procedure at Massachusetts General — a cost difference of 988 percent.
The Attorney General’s office, Massachusetts General Hospital and the Massachusetts Hospital Association had no immediate comment.