NEWPORT NEWS, Va. — Less than 30% of Virginia hospitals are complying with a newly-codified Virginia law, according to one advocacy group.
Patient Rights Advocate released their July report, finding that 34 hospitals in the Commonwealth are not up to standards when it comes to hospital price transparency. Out of the dozens of hospitals in Virginia, the group only found 13 to be "fully compliant."
"When hospitals hide behind estimates or don’t post all real prices, they are leaving consumers in the dark," Patient Rights Advocate President Cynthia Fisher said in a statement.
For the past two years, federal law has mandated that all hospitals post their prices on their website for patients to access. However, Virginia lawmakers codified the law and it went into effect in July after advocates said few had actually committed to it.
Dr. James Tinsley, a family physician of more than 20 years in Newport News, said he drove to Richmond to speak in favor of the law before the Senate's sub-committee. He said the law is beneficial but leaves hospitals with too much wiggle room.
"I'm surprised it's only 34 hospitals that are not compliant... in all honestly, it's probably more," said Tinsley.
Hospitals such as Sentara Norfolk General Hospital and Bon Secours Maryview Medical Center are among several to not be in "compliance" with Virginia law, according to Patient Rights Advocate.
A spokesman with Sentara Health released the following statement:
“Sentara came into full compliance with the federal CMS regulations in October 2021 by posting machine-readable files for each of our 12 hospitals on the Sentara.com website. These files contain negotiated rates for procedures covered by government payers and health plans. We have also included a compliant price estimation tool on our website to ease patient navigation. Additionally, Sentara enhanced our price estimation tools to include self-pay options for patients without insurance. Patients with insurance can obtain the most accurate out-of-pocket cost information from their health plans.”
A spokeswoman with Bon Secours also released a statement:
"Bon Secours has met the CMS Hospital Price Transparency Requirement by providing a price estimation tool, which can be found here: https://mychart.mybonsecours.com/mychart/Guestestimates?_ga=2.33842594.200347863.1657558891-1272535560.1631049948, and by publishing our insurance prices in the machine-readable file format, which can be found for each hospital, here: https://www.bonsecours.com/patient-resources/estimate-your-cost.
"Bon Secours believes in price transparency and empowering consumers to know more about the cost of their care. Because health care is complex, we will work closely with patients and their families to provide information about the payment for their care, what their insurance covers and ultimately what their out-of-pocket expense may be.
"We encourage patients to call 1-855-838-4604, Mon - Fri, 8 a.m.-6 p.m. to discuss their individual situation so they can obtain an estimate based on their individual payor guidelines. Our teams are ready to help patients and their families understand the cost of their care and resources available to them, at any time during the treatment process. Our Mission is to improve the health of our communities and to care for all in need, regardless of ability to pay."
However, Tinsley said even hospitals that are found to be complying can release data that is not always user-friendly.
"You have to know the CPT codes and it's downloaded into an Excel sheet, and then you have to know Excel and how to search through the sheet... so imagine your grandmother trying to do that, she still can't find it," said Tinsley.
According to a Gallup poll in 2022, four out of 10 Americans will put off the care they need because of the costs they could face.
If a patient has trouble finding a hospital's listed prices, advocates say it is your right to ask for the price before agreeing to any treatment.