Many nationally recognized cancer centers aren’t complying with price transparency rules

Only one-fifth of National Cancer Institute-designated cancer centers are complying with recently enacted price transparency rules, according to new data.

The Centers for Medicare & Medicaid Services began mandating hospitals to post prices negotiated with insurers back in January. But many haven’t abided by the policy designed to improve affordability.

One study found a whopping 94.4% of hospitals were noncompliant. A similar trend was observed across 63 NCI cancer centers, with only 21% posting a complete machine-readable file, as is required by CMS.

And while a majority offered patient-friendly price transparency tools, cancer centers are still falling short of expectations.

“Most NCI-CCs are poorly compliant with the 2021 CMS price transparency rules, potentially stymieing efforts to limit proliferating cancer treatment costs and improve affordability for patients,” Fumiko Chino, MD, with Memorial Sloan Kettering Cancer Center’s Department of Radiation Oncology, and co-authors wrote in JAMA Oncology.

Their conclusions are based on prices posted by 63 NCI-designated cancer centers. Chino et al. analyzed if the institutions had a machine-readable file and a display of 300 “shoppable” services in an easy-to-read format.

Overall, 38% had at least a partial machine-readable file. Additionally, 65% had a price transparency tool for patients and 70% posted a chargemaster list. Chino and co-authors did note some centers were charging up to 8 times the Medicare maximum allowable rate.

CMS has started sending warnings to non-compliant organizations, which face a maximum of $109,500 in annual penalties. Given this, the authors said it is “unsurprising” why so few are abiding.

Many NCI-CCs will likely continue to keep their pricing opaque given the potential reduction in reimbursement that may follow true transparency,” Chino et al. concluded.

Read the full research letter here.

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