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Employers Face Liability Over Hospital Prices in Health Coverage

April 26, 2022, 8:20 PM

Employer-run health plans must learn to use newly available hospital price data to determine fair prices or they could face legal action from plan members.

That was the message delivered in a webinar Tuesday sponsored by the National Alliance of Healthcare Purchaser Coalitions, which includes groups that represent employers that sponsor health plans.

The Consolidated Appropriations Act enacted in 2020 requires employer-sponsored health plans, acting as fiduciaries, to pay a fair price for services provided, and it requires hospitals and health plans to make the prices paid public. If health plans don’t, “there could be legal action from plan members,” ...