Hospitals have to be transparent about their prices by posting them online. That’s because of a Hospital Price Transparency Rule that went into effect a few years back. In New Mexico, fewer than half of hospitals are following that rule.
Cynthia Fisher, founder and chairman of the advocacy group Patient Rights Advocate, said the federal rule is meant to prevent hospitals from charging different prices depending on the patient and sticking people with surprise bills.
“The big picture is when hospitals and insurance companies continue to hide their prices, they can charge whatever they want, and that's exactly what's happening,” she said.
Only 43% of New Mexico’s hospitals are following the rule, according to a report from Fisher’s organization. That’s up from last year, when only 36% were following it. The national rate is currently about 35%.
Lovelace Hospitals – which are part of Ardent Health Services – were all found to be noncompliant. Christus St. Vincent Regional Medical Center in Santa Fe and Presbyterian Hospital in Albuquerque were also not following the rule.
Amanda Schoenberg, a spokesperson for Presbyterian, said the hospital is compliant with the Center for Medicaid and Medicare Services and is transparent about pricing for Medicare patients.
“At Presbyterian we are committed to transparency in healthcare, including helping patients understand the charges they receive for their care,” she said.
UNM Health, Los Alamos Medical Center and hospitals that are part of Community Health Systems were compliant with the rule.
Fisher said people with insurance through private companies and on the exchange through the Affordable Care Act tend to pay more than what the government pays through Medicaid and Medicare.
“We're seeing that a lot of these big insurers are not serving us well, by negotiating high, high prices above what would be a fair market rate,” she said.
Fisher said that of the about 2,000 hospitals the study looked at, only 2 had paid fines of over a million dollars for not complying with the new rule.
This coverage is made possible by the W.K. Kellogg Foundation and KUNM listeners.