In its fifth semi-annual report examining hospitals’ compliance with the federal Hospital Price Transparency (PRA) found that North Carolina came in 7th place in the U.S. for hospital price transparency. 

The nonprofit organization based its findings on a study of 2,000 hospitals nationwide. It revealed that only 721, or 36%, hospitals fully complied with the rule, which took effect nearly three years ago.

The study also found that a significant number of hospitals posted complex and hard-to-read files without user documentation, making them unusable in some cases.  

A random sampling of 44 hospitals was looked at across North Carolina. 

They found that 25, or 57%, fully complied with the rule, while 19, or 43%, weren’t. 

UNC Medical Center and UNC Rex Healthcare, Atrium Health, and Novant Health were among those that were found to be compliant, and Duke University Hospital and WakeMed Raleigh were among those that weren’t, the same as a report from February. In addition, Duke Children’s Hospital & Health was also found to be non-compliant. 

Both Duke and WakeMed did not return comments prior to the publication of this article. 

“Unfortunately, our findings show that the majority of hospitals across the country are still failing to comply with the Hospital Price Transparency Rule,” said Cynthia Fisher, founder and chairman of PRA, in an emailed statement. “When hospitals hide behind estimates or don’t post all real prices, they are leaving consumers in the dark. Making all actual prices available upfront will empower patients, employers, and unions to choose the best care at prices they know they can afford and protect all Americans from overcharges, errors, and fraud.”

According to Fisher, the organization is focused on lowering the cost of healthcare and empowering consumers to be well informed about all prices systemwide in healthcare so that they can have choices and prevent them from being overcharged. 

“People need financial certainty and need actual prices,” Fisher told Carolina Journal in February. “Estimates don’t really work because they’re not accountable, but actual prices are accountable. In order for all these hospitals to bill their patients every day, they know these prices in advance, and they also know how to convert the formulas into dollars and cents, and they clearly know every plan name and every procedure name and code.”

The rule for hospital price transparency came from the Affordable Care Act or Obamacare, but turning it into standard practice has taken time.

The Trump Administration made it into the rule of law, requiring that hospitals post all prices online as of January 1, 2021.

A bill dealing with medical debt and billing in North Carolina, S.B. 321, Medical Debt De-Weaponization Act, has been sitting in the House Rules Committee since May 3. Its fate looks to be similar to H.B. 1039, also known as the Medical Debt De-Weaponization Act, which stalled out in a House Banking Committee hearing in June 2022.