News outlets and social media platforms alike are filled with stories from Americans having to deal with their hospital bills being far too costly. (Related: Money grabbers: US hospitals are not complying with cost transparency rules; patients getting ripped off.)
On TikTok, people regularly take videos discussing their horrid experiences with medical billing. One user, Tre’Jon Wilson of New Jersey, wrote: “Tell me why my hospital bill went from $4,000 to $950 all because I asked them for a receipt and list everything I was being [charged]for. They lowered my bill by 76 percent. Is it me or [is]our healthcare system a scam?”
Another user who goes by the username @AmandersRuns, a real estate agent and marathon runner, discussed how a hospital charged her over $3,600 for four doses of acetaminophen she was given while undergoing a cesarean section.
Lack of transparency harming hospital patients
In 2019, former President Donald Trump signed an executive order requiring both hospitals and insurance companies to be transparent about what they charge for medical services, noting that Americans have a right to know the costs of services before visiting doctors.
The order went into effect on January 2021. These regulations included a requirement for hospitals to disclose prices for “shoppable services” in a way that would be easily understood by patients. Unfortunately, the Centers for Medicare and Medicaid Services (CMS) may not be enforcing these new regulations.
In a survey of just 600 out of over 6,000 American hospitals, the CMS claimed that around 70 percent are already complying with two key requirements: listing prices in both a machine-readable file that can be scanned by computer systems and a consumer-friendly display version of these lists.
However, according to a survey of 2,000 hospitals conducted between December 2022 and January 2023 by PatientRightsAdvocate.org, only 24.5 percent of hospitals are fully complying with the rule and posting complete price information. Some of the nation’s largest medical systems even had compliance rates of zero.
Not knowing the proper prices regularly leads to hospitals overcharging their patients. Andrea Mew, writing for Evie Magazine, noted how hospital coders regularly teach doctors how to “upcode,” or charge a patient’s charge more than what it’s actually worth.
“On a recent trip to Carlsbad, New Mexico, to help a patient who was overcharged for a CAT scan, I decided to walk over to the hospital’s radiology counter to ask how much a CAT scan of the abdomen actually costs,” noted Dr. Marty Makary, a professor of surgery and health policy at Johns Hopkins University School of Medicine. “I gave the radiology representative the exact medical code for the procedure. She said it would cost ‘about $5,000.’”