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Capsule: Public Has Its Say on Health-Care Cost Disclosure Rule

Jan. 27, 2020, 11:00 AM

Welcome to Capsule, where we’ll give you your weekly dose of what to watch out for in the health-care space. Each week reporters Ayanna Alexander and Jacquie Lee get you prepped for the week’s hottest health-care topics.

Ayanna: The public has had its say on making health-care costs transparent. With the comment period closing Wednesday, a trio of federal agencies now has to plow through the roughly 8,000 comments on the price transparency proposal, which is central to the Trump administration’s push to contain medical costs.

The measure—issued by the Department of Health and Human Services, the Department of Labor, and the Department of the Treasury in November—intends to clarify and make health-care prices available for consumers.

Any insurer that offers health plans or policies that were implemented after March 23, 2010, are required to make patient-specific out-of-pocket cost data for all covered services accessible to participants, beneficiaries, and enrollees, according to the Centers for Medicare and Medicaid Services.

Those insurers also have to electronically inform consumers, researchers, employers, and third-party developers of past payments made to out-of-network providers.

Jacquie: This is one avenue of the administration’s effort to make health care more transparent and affordable—something voters care deeply about. There are almost 8,000 comments on this particular policy suggestion.

The underlying demand across the board is health care should be treated like any other business: customers should know what they’re buying and how much it costs.

And the transparency issues the rule tries to fix bleed into other policy debates happening on Capitol Hill, including surprise hospital billing. A mother describes a visit to urgent care where her daughter gets stitches on her chin removed. They initially walked away having paid their $50 co-pay, but a couple of months later a bill for $800 arrived in their mailbox because they were out of network.

If that had been clear to the family they would have gotten care elsewhere, she wrote.

Another commenter describes their frustration when calling insurance providers to figure out how much they’ll have to pay out of pocket for medication in the upcoming year “only to be told they don’t know yet.”

“How am I to make an intelligent choice of providers when I can’t get the pricing info upon which I make my decision?” the commenter wrote.

What We’re Watching

Congress and health officials are keeping a close eye on the spread of the coronavirus that’s building in China and popping up in the U.S. Senators were split on how to handle it in a Jan. 24 meeting, so expect more conversations among lawmakers as the situation develops. The Centers for Disease Control and Prevention says it has been prepared for the coronavirus to hit the U.S. for weeks and is handling it with screenings at airports and its Emergency Operations Center, the agency’s director, Robert Redfield tweeted.

We’re also looking out for influenza trends. The flu typically hits its peak in February, health officials have said previously.

At least 50 pediatric flu-related deaths have been reported as of Jan. 18, according to the CDC.

The House is coming back this week and our Hill reporter Alex Ruoff says Democrats are gearing up to take on teen vaping in the next few weeks. Keep an eye out for additional vaping and smoking bills to hit the floor soon, he says.

The House Energy and Commerce Committee will also debate legislation that affects the Food and Drug Administration on Wednesday.

HHS’ Office of the National Coordinator for Health Information Technology is hosting its two-day annual meeting Monday.

Health IT representatives will come together in Washington to discuss a wide variety of topics such as the potential for a patient identification system, patients’ right to access their records, burdens surrounding electronic health records, and seamless data sharing. We’ll have several colleagues listening in, so be on the lookout for that.

This meeting comes as ONC and the health IT industry awaits the agency’s data sharing provision, which is still sitting at the White House. Sources say the review could wrap at the beginning of February.

ONC also plans to highlight price transparency during the annual meeting.

The agency’s health IT committee recently discussed its roadmap plan, which it will submit to HHS and Congress this spring. The committee hopes to address how health IT developers and health-care providers can use data from outside sources and offer ways that health IT can improve price transparency within health care during a meeting in February.

Developments are expected Tuesday in a lawsuit alleging that 20 generic drugmakers coordinated to price-fix their products. The 44 state attorneys general who brought the case will be filing an opposition to Pfizer’s motion to dismiss and motion to stay discovery.

To contact the reporters on this story: Ayanna Alexander in Washington at aalexander@bloomberglaw.com; Jacquie Lee in Washington at jlee1@bloomberglaw.com

To contact the editors responsible for this story: Fawn Johnson at fjohnson@bloomberglaw.com; Andrew Childers at achilders@bloomberglaw.com

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