As of this year, hospitals across the country have been forced to disclose their fees for certain medical procedures as part of a new federal rule in order to bring a little more transparency to the public health sector. But according to a new Wall Street Journal investigation, hundreds of hospitals across the country have found a relatively sneaky way to prevent the public from eavesdropping on their proprietary price data.
Researching the back ends of more than 3,000 sites belonging to hundreds of hospitals, the Journal found that the price disclosure pages for hundreds of them were incorporated into a small code to prevent the price disclosure page from being displayed on Google and other search engines. In total, according to the report, disclosure files from about 300 different hospitals have been incorporated into this piece of code, although a little more than half – 182 – removed the excerpt from their page after being contacted by the Journal.
To step back a little, these new transparency rules are basically derived from a Executive Order 2019 signed by then-President Donald Trump, who created a system for hospitals to disclose the prices that insurers and patients pay for common items and services, including X-ray tests and certain minor surgeries, among others. As part of these new rules, hospitals are required to post these prices online in a “machine readable format”That can be easily discovered by a health-conscious consumer while researching procedures connected.
In addition, this data file needs to be displayed “prominently” on the public consumer-facing website of the hospital, and the hospital needs to ensure that these pages “are easily accessible and barrier-free”.
Good intentions aside, we saw health professionals fight to implement the new law due, in part, to how ambiguous this is. Previous reports have pointed that the vague requirements imposed on hospitals as part of these new rules often result in price lists that are difficult – if not totally – impossible to find, even if the lists are technically “machine readable” and “on the internet”. In the meantime, as the Journal points out, the order does not specify exactly how many details these hospitals should offer in their price sheets – meaning that it is up to hospitals to include or not include fees for specific health plans, or whether they simply want to include fees of different plans in the aggregate.
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Then there is the new report from the Journal. The hospitals at the center of this new investigation – which included facilities owned by big names like HCA Healthcare and NYU Langone Health – were found to incorporate a specific code string is intended to prevent your pricing page from being indexed by search engines.
This means that while the page technically exists online, there is no way to appear inside search results, no matter how many other sites may link to it or the phrases you connect to the search engine. The only way to find these pages, ultimately, is to crawl the sites on your own and see which pages can be flagged with the snippet of non-indexing code.
Three of the major hospital chains found using this stretch – including Penn Medicine and NYU Langone – told the Journal that they implemented it as a way of directing patients to information that may be more informative than a jumble of raw price data. It’s a scruple that we saw playing in court last year. ÇWhen the Trump administration first tried to pass this new law, one of the reasons that major groups of hospitals ended up Lobging a lawsuit back to administration was the argument that the rule “would cause confusion about patients’ financial obligations, it would not suppress it”.
That said, it is important to note that some hospitals claim that not all of these search block code snippets were left intentionally. In some cases, after being contacted by the Journal, hospitals removed the snippet from their website, saying it was a piece of “legacy code” that was no longer needed. Others said the code was left on their website “by mistake”. In some cases, the code may have been left while hospitals worked to restrict these price pages as a way to prevent the document being indexed in search – and the person responsible for the page simply forgot to remove the snippet.