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AHIP Comments on CMS Proposals That Would Require Public Disclosure of Negotiated Prices

Press Release

Published Sep 27, 2019 • by AHIP

WASHINGTON, D.C. – Matt Eyles, president and CEO of America’s Health Insurance Plans (AHIP), issued this statement following AHIP’s submission of comments on the Centers for Medicare & Medicaid Services’ (CMS) Outpatient Prospective Payment System proposed rule:

Every American should be able to get the health care cost and quality information they need, when they need it, in a way that’s customized and personal to their own circumstances. With this information, people can make informed health care decisions for themselves and their family. Health insurance providers support transparency initiatives that advance these commitments. Greater transparency across our health care system for consumers that truly aids and empowers them is essential to achieving our shared goal of more affordable, comprehensive coverage and high-quality health care choices for every American.

But forcing disclosure of privately and competitively negotiated rates, as the proposed rule describes, will not provide consumers with information that is actionable or helpful. Instead, it will hamper competitive negotiations and push health care prices and premiums higher for patients, consumers, businesses and taxpayers.

This proposed rule also has significant implications for, and is interconnected with, other proposed rules regarding interoperability of health care data. We are concerned that unknown entities will have open access to the data, with few restrictions on how they may use it. Without clear consumer protections governing how that data can be used, patients’ privacy will be put at risk – as health care information could be bought and sold in the open market and combined with other personal data by unknown actors and for unknown purposes.

Health insurance providers unequivocally want to empower patients and consumers with health care cost and quality information that is simple, clear, and personally relevant. That’s why the vast majority of health insurance providers offer cost estimator tools through their secure member portals and mobile apps. We urge the Administration to withdraw the negotiated price disclosure provisions of the proposed rule, and we stand ready to engage collaboratively with the Administration and other health care stakeholders to find better solutions to lower prices and costs while protecting health care quality, choice, value, and privacy for the hardworking Americans we serve.

Click here to read AHIP’s full comment letter.


About AHIP

AHIP is the national association whose members provide coverage for health care and related services to millions of Americans every day. Through these offerings, we improve and protect the health and financial security of consumers, families, businesses, communities and the nation. We are committed to market-based solutions and public-private partnerships that improve affordability, value, access, and well-being for consumers. Visit www.ahip.org for more information.