The FTC Warned 24 Large Healthcare Companies That Following CMS Price Rules Is No Shield Against a Deception Case
The Federal Trade Commission said on 5 October that Chairman Andrew Ferguson had sent warning letters to large US healthcare services companies, reminding them that failing to give patients timely, accurate and complete prices can be an unfair or deceptive practice under Section 5 of the FTC Act. The letter flags omitted physician or facility fees and estimates covering only part of a course of care as potentially deceptive, and late or inaccurate prices for scheduled care as potentially unfair. It calls CMS’s price transparency rules a regulatory floor that does not provide a safe harbour from FTC liability. The letters require no reply and make no finding of a violation.
A hospital can now meet every CMS posting rule and still face a deception case. The FTC’s theory turns on what a patient is told before scheduled care. CMS quoted Ferguson in its own transparency release the same day, so the two agencies are working the same problem from both ends.
- Health systems: the exposure is the patient estimate. The letter’s examples are fees left out of a quote and estimates that cover only part of the care, which sit in scheduling and billing rather than in the machine-readable files built for CMS. The estimates patients actually receive are what to review first.
- Drug and device makers selling direct: the same standard reaches any price shown to a patient. The FTC and states sued Lens.com the previous week over contact lens prices in search ads and on its website. Cash-price and direct-to-patient programmes that quote a price without the full cost of care sit within reach of the same reasoning.
- Signposts: names, a first case and the states. Watch whether the FTC identifies the recipients, whether a Section 5 case against a provider follows, and whether state attorneys general join, as they did against Lens.com.
Read the original source (FTC) →
Read the letter template (FTC) →