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Insurers and employers have been required to publish their negotiated rates for hospital and physician services every month for more than four years under what is known as the Transparency in Coverage regulation. But those data files have been filled with unusable data known as “ghost rates” or “zombie rates” — prices for services that would never happen, like if a dermatologist were to perform an open-heart surgery. Some research has suggested more than 90% of the prices are ghost rates.

Trump officials said insurers and their vendors have been purposefully gumming up the datasets with these numbers to make it more difficult for the public to understand what the true, relevant prices are, and they are attempting to put a stop to it.

“The evasive action was just to flood the zone with so much information that instead of enlightening the process, it actually obscured it further,” HHS Secretary Robert F. Kennedy Jr. said at an event Monday. “The information was impossible to decipher, and even the employers who have hundreds of attorneys working for them could not figure out the differentiation in prices.”

  • gravitas_deficiency@sh.itjust.worksEnglish
    39·
    13 days ago

    Simply because we are talking about the orange regime here, there is a roughly 100% chance of at least one of the following:

    • someone friendly with the regime is getting a big fucking kickback
    • physicians/nurses/specialists/etc (actual care providers) will get screwed over in some fashion
    • patients will get screwed over in some fashion

    So, no, despite the wrapping paper, I do not believe this will actually end up being Uplifting News.

    • Doomsider@lemmy.worldEnglish
      2·
      12 days ago

      They are trying a ham fisted attempt at making medical care cheaper. The reality is they are undoubtedly playing into the hands of a special interest that wants this data to be accurate.

      Just like Kennedy’s MAHA health care information grab, this is probably some scheme to eventually replace medical care with AI.

  • Sarah Valentine@pawb.socialEnglish
    19·
    13 days ago

    “The evasive action was just to flood the zone with so much information that instead of enlightening the process, it actually obscured it further,” HHS Secretary Robert F. Kennedy Jr. said at an event Monday.

    That has been the hallmark of this entire fucking administration, himself included. Their every accusation is an admission.

  • BehindetheClouds@reddthat.comEnglish
    4·
    12 days ago

    Not to be a Debbie Downer but I think it’s more like blackmail.

    Give us boatloads of money or we will expose how you’re rat fucking people.

  • yesman@lemmy.worldEnglish
    3·
    13 days ago

    Trump aside, this is good. Healthcare prices are intentionally obscure and inaccurate in the US.

    For any given procedure or equipment, the manufacturer/provider will have a price called the “billed amount”. This is a fictional number that serves as a negotiating position. The insurance company has an “allowable” which is what they’ve negotiated with providers to actually pay. Every year the insurance companies and medical providers negotiate on the actual price. So providers are incentivized to inflate their costs in hopes of getting a better deal.

    Usually, the difference between the billed and the allowable vanishes. But the patient may be on the hook, depending on circumstances. I know people with decades of experience in the industry who still get confused and struggle dealing with insurers.

    The moral of the story is that if you ever have to pay medical costs out of pocket, the first thing you should do is ask to reduce the prices from the fictional and inflated “billable” down to an “allowable” amount, usually using Medicare’s allowable as a standard.

  • Artisian@lemmy.worldEnglish
    2·
    13 days ago

    Very little coverage on this one; it’s been a longstanding issue. Anybody extracted the executive order text/rule change?