The new majority in Virginia’s House of Delegates is acting to lower healthcare costs—and for patients to make informed decisions. A House subcommittee recently approved legislation that would put teeth into the movement for price transparency, so that all patients at hospitals in the Commonwealth would know the price of the care they receive before they receive it.
The bill, HB 2427, by Rep. Nick Frietas (R-Culpeper), would strengthen the enforcement of existing requirements for hospitals to provide price information to patients and the public. Specifically, hospitals must provide patients with an estimate of costs for every elective test or surgery three days in advance of the procedure. In addition, hospitals must comply with federal regulations that require facilities to post their price data in a machine-readable format—the better to allow companies like Expedia to create tools or apps that let patients easily compare hospital prices.
The bill states that, if hospitals do not comply with these existing requirements by July 1, patients have the right to pursue legal action against the hospital for the cost of their treatment. In the case where a hospital knowingly did not comply with the law, courts could assess damages of up to three times a patient’s charges.
As one might expect, hospitals have said they oppose HB 2427. But more than one year after the federal requirements first took effect in 2021, a survey completed last August found that only 20% of Virginia hospitals met the federal standards. This legislation would be entirely unnecessary if hospitals in the Commonwealth had fully complied with federal law in a timely manner. But since hospitals have failed to act, and bureaucrats in Washington have yet to intervene to protect Virginia patients, lawmakers in Richmond should do so themselves.
The complaints coming from the hospital industry over the notion of patients suing them for violating the law seem particularly ironic, given the way many hospitals have behaved until very recently. One 2019 expose found that the University of Virginia Health System sued patients—including its own employees—in court for amounts as little as $13.91. Another study, published in the Journal of the American Medical Association, found that Virginia hospitals filed over 20,000 lawsuits against patients in 2017.
In that sense, the legislation gives hospitals a proverbial taste of their own medicine, by opening them up to the same treatment they inflicted on patients—many of them poor, vulnerable, and in financial distress—over the years. In fact, HB 2427 prohibits hospitals from filing lawsuits against patients if they refuse to comply with its transparency requirements. This provision will ensure that patients will not suffer the indignity of getting sued when they cannot pay a bill that costs far more than expected because they did not have access to price information in the first place.
Obviously, price transparency will not solve all the problems within the healthcare system. For instance, no one should expect a patient in cardiac arrest to spend time searching for prices while in an ambulance on the way to the hospital.
But multiple diagnostic tests, ancillary services, elective procedures, routine primary care visits, and their associated tests are “shoppable”—in those case scenarios, patients can decide precisely where and when they will receive the service. In these cases, price transparency would prove invaluable for patients, particularly the uninsured or those who have yet to meet their annual deductible. HB 2427 would give patients the tools they need to shop around for services or to negotiate with their doctors and hospitals for a more reasonable price.
As health analysts, one is the mother of a daughter with cystic fibrosis, and the other is a healthcare administrator with both clinical and management backgrounds, we know how badly health costs have skyrocketed—and how those costs affect the families of those needing care. We know that HB 2427 will finally force hospitals to do the right thing—that’s why they oppose it so strongly—and that transparency will help us and our fellow Virginia residents. It is our hope the House of Delegates passes the bill, and Gov. Youngkin has a chance to sign it into law.