More than half the hospitals in Pennsylvania aren’t complying with federal price transparency rules, according to a new report by the Pennsylvania Health Access Network.

A federal review released last fall by the U.S. Health and Human Services Office of Inspector General reached a similar conclusion, estimating that 46% of hospitals haven’t been complying with the Hospital Price Transparency Rule, which has been in place since 2021.

The federal government has not been taking enforcement action against hospitals for noncompliance, meaning the state should fill the gap, said Antoinette Kraus, executive director of the health access network in a press call Tuesday.

Senate Bill 752 and House Bill 1469 would set state hospital price transparency rules and empower the Department of Health to sanction hospitals that fail to post the costs of medical procedures.

Penalties for noncompliance

Hospitals that refuse to comply would face civil monetary penalties, beginning at $2,500 for the first incident, with the fine escalating until it hits $15,000 for the fourth and subsequent violations.

Both bills would also bar hospitals from collecting medical debt if the hospital hasn’t complied with the transparency requirements. The legislation would also allow patients to sue to get their debt eliminated if the hospital hadn’t satisfied the price transparency rule.

SB 752, prime sponsored by Sen. Dawn Keefer, R-York, was introduced in May and referred to the Senate Health and Human Services Committee.

HB 1469, prime sponsored by Rep. Tarik Khan, D-Philadelphia, was also introduced in May. The House bill has been referred to the House Health Committee.

The lawmakers said that the transparency requirements are essential to help patients make informed decisions about getting medical care.

“I’ve been a nurse for about 20 years. I can tell you, one of the worst things that a patient can get when they’re having a health care issue is a surprise medical bill, knowing that they’re going to go into the hole for thousands and thousands of dollars,” Khan said. “A lot of the issue is that when patients go to access health care, especially when they are in hospitals, they have no idea of the cost of things.”

Keefer recounted the experience of a constituent who’d tried to pay for medical care out-of-pocket only to get hit with a bill that was nearly double what he’d thought it would be.

“He got an estimate of $1,800,” only to receive a bill for $3,000, Keefer said. “That just opened a bigger can of worms… We had this rule in place saying, ‘Hey, you just have to publish these prices, but what we keep finding is, it’s not consumer-friendly data that they’re actually publishing and many hospitals are just using price estimators.”

Patrick Keenan, policy director for the health access network, said that the group’s review found that in many cases, even when hospitals complied with the transparency rules, the information was difficult for consumers to read or understand.

“Twelve hospitals were compliant, but had data files that were formatted in a way that made it difficult to open and easy to understand,” he said. “These are some of the reasons why we need a state-based solution. The [federal] rules have kind of set the path, and what we really need to focus in on is compliance and making sure that patients can access this data.”