For too long, patients in the United States have had no knowledge of the true cost of their health care and aren’t aware of what they must pay until after they receive it. And now, as premiums and out-of-pocket costs continue rising each year, the lack of upfront pricing leaves patients and their families vulnerable to surprise bills, medical debt, and financial stress. The federal government has taken action to implement price transparency so patients can take control of their medical expenses, but there is still more to be done to ensure that price transparency becomes the new normal in our healthcare system—and the states are playing a big role in that.
Earlier this year, the Oklahoma legislature passed Senate Bill 889, a price transparency law that will go into effect on November 1st. It codifies the federal hospital price transparency rule implemented by the first Trump administration beginning in 2021. This federal rule, and now the Oklahoma law, require hospitals to publish easy-to-understand prices for 300 common services, including discounted cash prices, payer-specific negotiated rates, and minimum and maximum negotiated rates.
Those 300 common services must include the 70 shoppable services determined by the Centers for Medicare and Medicaid (CMS) as shoppable, if they are provided. These are non-emergent services that can be scheduled ahead of time, meaning that patients and their families can compare prices before scheduling to inform their decision of where to get that service. Examples from the CMS list include psychotherapy, CT scans, blood tests, and even joint replacement surgery.
While the federal rule already requires hospitals to comply, state laws can reinforce these standards and strengthen enforcement. Federal guidance can change over time, so codifying transparency at the state level helps maintain a consistent expectation for patients and providers alike. It also enables stronger accountability.s. As of November 2024, only 21.1% of hospitals nationwide, and about 12% in Oklahoma, were in full compliance with the federal price transparency rule. This is likely due, in part, to CMS having fined only 27 hospitals to date. Now, hospitals in Oklahoma that are not in compliance with price transparency rules will not be able to collect on patients’ debt, further incentivizing compliance.
Oklahoma is the latest in a wave of states to pass similar legislation. As of November 2024, there are 24 states that have codified the federal rules or gone beyond them to add enforcement mechanisms. For example, Colorado passed legislation in 2022, also banning hospitals from collecting medical debt if they are noncompliant.
The movement to implement price transparency in health care represents an important step toward curbing rising costs.. When patients have knowledge of pricing to inform where to receive their care, they can plan for their medical expenses ahead of time and save money if they choose cheaper care options. Not only does this empower patients individually, but it also means that hospitals and third-party payers will have to become responsive to the choices all patients make. Rather than setting prices based on what they negotiate among themselves, they will have to set prices based on what will get patients to choose their services over their competitors, slowing or even reversing the trend of never-ending price hikes.
As more states follow Oklahoma’s lead, price transparency is shifting from a policy goal to a practical reality that puts patients first. By codifying federal rules and adding meaningful enforcement, Oklahoma is helping to ensure that price transparency isn’t just a temporary reform, but a lasting standard in our healthcare system, where patients are empowered to make the best health and financial decisions for themselves.