RALEIGH, N.C. (WNCN)– North Carolina State Treasurer Dale Folwell (R) claims some North Carolina hospitals are not complying with federal price transparency rules.
As of the beginning of this year, those rules require hospitals to post their prices for the public to see. Folwell goes so far as to call the healthcare system a cartel.
“A cartel in the Webster’s Dictionary is defined as an association which is formed to restrict competition and raise prices, we have the cartelization of healthcare here in North Carolina,” Folwell said.
“The idea that we’re operating as a cartel isn’t just insulting, but ignores the reality of the millions of dollars of charity care we spend every year, not just during a pandemic, to care for our communities” said Cody Hand, deputy general counsel for the North Carolina Healthcare Association.
Hand says his organization has been working with the treasurer’s office for several years.
“And all of the data that he claims to be unavailable is available. Not only to him, but on the websites of every hospital to everybody who clicks on the links” said Hand.
CBS 17 checked several of those links. Pricing is available, although some of that data is not easy to sort out.
Folwell also claims his office can’t access data from the state employees healthcare plan (SHP) without permission from Blue Cross Blue Shield of North Carolina.
“Having access to our data is vitally important especially when you are talking about spending nearly 2.5 billion dollars mainly of tax payer money” said Folwell.
But Hand says Folwell is the one who negotiated the latest contract.
“And if he didn’t negotiate access to that data into that contract, then I believe he failed as the fiduciary of the plan and the tax dollars to get that done” said Hand.
Folwell responded by saying “my job to is to protect those who teach, protect and otherwise serve, and taxpayers like them. The North Carolina Healthcare Association is there to protect multibillion-dollar nonprofit hospitals that pay their executives millions of dollars. The American Hospital Association said transparently disclosing prices does nothing to help patients understand what they actually pay. How bizarre. I’m glad to hear NCHA has changed its position and is now supporting transparent prices.”
Blue Cross Blue Shield of North Carolina sent the following statement:
“Blue Cross and Blue Shield of North Carolina (Blue Cross NC) supports full transparency and Treasurer Folwell’s efforts to provide high quality, affordable care to State Health Plan members and their families. Under current law, we provide the State Health Plan full access to data, including billed amount, allowed amount, contracted rate, and paid amount for each claim paid on behalf of State Health Plan members. We are committed to working with the Treasurer on legislation that would increase the State Health Plan’s ability to use provider rate data more broadly, but we cannot support language that would allow the State Health Plan to reveal these rates to competitors without requiring the same transparency from all insurers. For transparency to work, it must apply to every insurer in the state, not just one.
Federal transparency rules will soon go into effect that will require increased transparency for all insurers. We look forward to working with the State Health Plan to align state law with these new requirements and to ensure that the Plan has the information they need to provide quality and affordable health care to state employees.”
State Health Plan Data Transparency House Bill 169 is currently making its way through the North Carolina General Assembly. Folwell says it will help address his concerns while Hand says it’s unnecessary.
Folwell is calling on NC Attorney General Josh Stein (D) to get involved.
Stein’s office tells CBS 17 he has been looking closely at this issue and will continue to do so.
“You look at the impact that surprise billing, medical billing, the cost of insurance and out of network billing is having on the lower fixed income people of this state this is something that is unacceptable to me as state treasurer” said Folwell.
