By Matthew Holloway |
Six Phoenix-area hospitals received federal warning notices or requests for corrective action plans over compliance with hospital price transparency requirements, according to a report released by the health care watchdog group Hospital Watch.
The facilities named were Banner Gateway Medical Center, BH Newco Hospital LLC, College Medical Center Phoenix, Phoenix Specialty Hospital, Quail Run Behavioral Health, and Valley Hospital.
BH Newco Hospital operates as Via Linda Behavioral Hospital in Scottsdale. Banner Gateway Medical Center is located in Gilbert, while the remaining facilities serve patients in Phoenix.
The six Arizona facilities were among 519 hospitals nationwide that received letters from the Centers for Medicare and Medicaid Services (CMS) between April and early June, according to a national list obtained by the Associated Press.
The list included hospitals in every state except Alaska. Texas had the most facilities receiving letters with 42, followed by California with 38, and Indiana with 34.
The letters included warning notices and, in cases CMS considered more serious, requests for hospitals to submit formal corrective action plans. Hospitals that fail to address cited deficiencies can face civil monetary penalties that may reach approximately $2 million annually, depending on the size of the facility.
“Patients should not have to guess what a hospital visit is going to cost,” Hospital Watch spokesman Adam Buckalew said. “If hospitals are serious about affordability, they should start by following the basic transparency rules already on the books. Instead, too many major hospital systems are hiding prices, protecting inflated rates, and leaving families to deal with surprise bills they cannot afford.”
Federal hospital price transparency rules have been enforced since Jan. 1, 2021. Most hospitals are required to publish a comprehensive machine-readable file containing their gross charges, discounted cash prices, rates negotiated with individual insurers, and the highest and lowest negotiated prices for each service.
Hospitals must also provide a consumer-friendly display covering at least 300 services that patients can schedule in advance, or all such services if the hospital offers fewer than 300. The display must include plain-language descriptions and pricing information or be provided through an online cost-estimator tool.
CMS can issue a warning, require a corrective action plan, impose a civil monetary penalty, and publicly identify hospitals that remain out of compliance.
The public list of hospitals receiving letters does not by itself disclose the specific deficiency identified at each Phoenix-area facility or establish whether the issue has since been corrected. Hospitals elsewhere on the list have said their notices involved technical or formatting problems rather than missing price information.
The University of Texas MD Anderson Cancer Center, for example, told the Associated Press that its notice concerned a date-field formatting issue that was corrected. Ascension said letters sent to several of its hospitals involved a minor technical error. CMS later accepted corrected documentation from some facilities.
A 2024 audit by the Department of Health and Human Services Office of Inspector General found that 37 of 100 sampled hospitals failed to meet one or more federal transparency requirements. The office estimated that 46 percent of the 5,879 hospitals covered by the rule were not fully compliant at the time of the audit.
Hospital Watch said inaccessible or incomplete pricing information prevents patients, employers, and families from comparing costs before receiving care. The organization also called for greater federal enforcement and additional scrutiny of hospital consolidation in the Phoenix market.
“The hospital market in the Phoenix area is dominated by a handful of powerful systems,” Buckalew added. “When hospitals buy up competitors and face little real competition, patients lose. Prices go up, premiums rise, and families are left with medical bills they cannot afford.”
A January report from the Arizona Health Care Cost Containment System (AHCCCS) identified Banner Health as the state’s largest hospital system with 18 hospitals, followed by Dignity Health and HonorHealth. AHCCCS listed Abrazo/Tenet among 11 hospital systems operating at least three facilities in Arizona.
Hospital Watch said private insurers and patients frequently pay hospitals approximately three times the rates paid by Medicare.
A nationwide RAND Corporation study found that employers and private insurers paid hospitals an average of 254 percent of Medicare rates for comparable services at the same facilities in 2022. Inpatient facility prices averaged 254 percent of Medicare rates, while outpatient hospital facility prices averaged 279 percent.
Hospital industry representatives have argued that commercial payments help cover costs that Medicare and Medicaid reimbursement rates do not fully address. The American Hospital Association has also said most hospitals comply with federal requirements and has called for clearer, more standardized rules that produce information patients can readily use.
“We need real enforcement of hospital price transparency and stronger scrutiny of hospital consolidation,” Buckalew said. “Sunlight is the first step toward accountability. Patients and employers deserve to know what they are being charged, why prices are so high, and whether hospitals are giving them a fair deal.”
Hospital Watch launched in February as a project of Better Solutions for Healthcare. The group advocates for hospital price transparency, limits on facility fees and markups, and increased oversight of hospital consolidation.
Matthew Holloway is a senior reporter for AZ Free News. Follow him on X for his latest stories, or email tips to Matthew@azfreenews.com.
