FACT SHEET: Improving Hospital Price Transparency in Oklahoma

NEXT STEPS TO IMPROVE COMPLIANCE IN OKLAHOMA

• Additional state policies can encourage greater compliance with federal requirements and give patients more control over their care and wallets.
• The Department of Health and Human Services finalized a rule in November 2019 that requires hospitals to publish prices. As of January 2021, hospitals are required to publish a machine-readable file of five types of standard charges for all items and services. They are also required to create a consumer-friendly, shoppable list of 300 items and services, including 70 identified by the Centers for Medicare and Medicaid Services (CMS).
• Full compliance with the federal rule, as defined by CMS, remains low nationwide and in Oklahoma. A Patient Rights Advocate report from this month estimates that approximately one quarter of hospitals nationwide are fully compliant.
• Codifying the federal rule and coupling it with additional monetary penalties are strategies that will help increase compliance. Preventing non-compliant hospitals from pursuing debt collection against patients is another way to safeguard patients and incentivize compliance. Examples of these policies can be found in Texas's SB 1137 (2021) and Colorado's HB 1285 (2022).

COMPLIANT HOSPITALS IN OKLAHOMA

• 8% of hospitals are fully compliant
• 92% of hospitals are not fully compliant or are non-compliant

WHY THIS MATTERS

Prices for healthcare services can vary greatly by location. According to data from Turquoise Health, the cash price for a routine colonoscopy is $1,350.25 at Oklahoma State University Medical Center in Tulsa, while the cash price at Norman Regional Hospital Authority just south of Oklahoma City is $184.00. This means a patient could save themselves more than $1,000 by driving about 2 hours to a different hospital.

THE POLICIES IN SB 732 WOULD PUT OKLAHOMA IN CHARGE OF THIER CARE

• The policies in SB 732, sponsored by Senator Nathan Dahm, add a private right of action and consumer protection terms that will deter non-compliant hospitals from pursuing debt collection against patients. As a result, a patient may sue a hospital and recover damages if the hospital is not posting prices and not complying with the price transparency rule, and the hospital initiates a collection action against the patient for an unpaid hospital bill (beyond the initial action of sending a patient a bill for services).
• Hospital price transparency is popular. Texas's SB 1137 law passed in both chambers unanimously in 2021, and Colorado's HB 1285 passed the Senate unanimously in 2022.