Friday, October 28, 2011

Lack of Transparency Continues to Haunt HHS

A lack of information is driving consumers into poor health care choices, and Health and Human Services is to blame; at least according tothe Government Accountability Office.

In a 43-page report released this September, the office slammed HHS, claiming that a lack of transparency is keeping consumers from easily accessing the pricing information of health care plans until after they are already covered. FierceHealthcare summarizes, “In one example, the agency contacted a variety of physician offices to get the price of a diabetes screening--and was consistently told an office visit was required prior to disclosure of such a price. The GAO also noted that the negotiated prices between an insurer and provider were often kept from consumers for legal and trade purposes.”

Transparency in HHS is not a new topic. In fact, the department was criticized for similar reasons when they removed public access to National Practitioner Data Bank in early September.

This new report, the creation of which was heavily pushed by congress, has found a severe lack of initiative from HHS when it comes totransparency.

Several health care and legal factors may make it difficult for consumers to obtain price information for the health care services they receive, particularly estimates of what their complete costs will be. The health care factors include the difficulty of predicting health care services in advance, billing from multiple providers, and the variety of insurance benefit structures.

The entire industry is keeping a close eye on this developing story, and Merrill Corporation will be among them.


Pam Argeris is a thought leader in the Healthcare Industry and possesses extensive, hands-on experience with CMS compliance, and multiple regulatory bodies such as NCQA, JACHO, and DOI. In her role at Merrill Corp., Pam focuses on developing solutions for compliance and quality assurance, delivered in a cost effective manner to improve beneficiary and prospect communications. You can contact Pam at

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