SPBA in talks with HHS on Hospital Transparency


CHEVY CHASE, MARYLAND (March 5, 2012) – Staff at the Society of Professional Benefit Administrators (SPBA) – including Chairman Robyn Jacobson – recently joined Actuary Hobson Carroll, FSA MAAA, in meeting with high-level U.S. Department of Health & Human Services (HHS) policymakers to discuss the Patient Protection and Affordable Care Act’s (PPACA) hospital transparency provision.

In October 2011, SPBA submitted Policy Brief Comments on Section 2718(e) of Title XXVII Public Health Service Act which deals with Standard Hospital Charges.  The subsection is loaded with words that have escaped common acceptance of their definitions and can change depending upon the stakeholders’ interpretation.

“The inherent struggle to reach a consensus of opinion on the what and how of expressing hospital charges to the public is a debate that could take decades more to resolve if we do not have legislation and regulations to facilitate this practice.  Talking with HHS on February 14, we elaborated on why the approach put forward in our Policy Brief Comments is vital,” said Mrs. Robyn Jacobson, SPBA Chairman.

Taking SPBA’s proposals on hospital transparency into serious consideration, high-ranking representatives from various government agencies participated in asking probing questions.

“Think of the empowerment to be gained by exposing the range of actual payments hospitals are willing to receive from different payers for more or less the same service, and the resulting innovation and creativity generated in benefit plan and provider reimbursement structure design, and the competition that will, using this first step, inexorably result in the market place,” enthused Mr. Hobson Carroll.

Even though the law exists as part of the Affordable Care Act, the regulatory process will take time to complete.  Functioning as a principal knowledge resource for regulators, SPBA is well-positioned to continue its dialog on the topic of hospital transparency until a workable and enforceable rule is implemented.

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