FTC Warns 24 Health Care Companies About Hidden or Misleading Hospital Prices: How to Protect Yourself From Surprise Costs

Federal regulators say a hospital price that leaves out key fees may be deceptive, a reminder to ask for the full cost before you book care.

On Monday, Oct. 5, the Federal Trade Commission, or FTC, said it sent warning letters to 24 major health care services companies about how they share prices with patients. The agency said that leaving out important costs, giving inaccurate prices or sharing them too late could violate federal consumer protection law.

The FTC did not name the companies that received the letters.

What the FTC is warning about

The FTC enforces Section 5 of the FTC Act, a law that bans "unfair or deceptive" business practices. In its announcement, the agency listed several pricing habits that concern it, including:

• Not giving patients timely, accurate and complete price information.
• Leaving physician or facility fees out of a quoted price.
• Sharing a price that covers only part of the care a patient will receive.
• Giving prices that are simply inaccurate.
• Not giving enough notice before a scheduled service.

The FTC put it plainly: "Failing to disclose the price of a healthcare service may be deceptive if the omission is likely to mislead consumers acting reasonably under the circumstances."

The agency also said that following the federal Centers for Medicare & Medicaid Services (CMS) price transparency rules doesn't automatically mean a hospital is meeting its duties under the FTC Act. In other words, posting a price list online is not enough if the prices patients actually see are misleading.

According to Becker's Hospital Review, the letters were sent by FTC Chairman Andrew Ferguson, who set up a health care task force in March. The FTC said it "will continue to monitor the healthcare marketplace and take enforcement action as warranted."

Why surprise medical costs hit so hard

Medical bills are one of the hardest expenses to plan for. A quote for a procedure might cover the hospital's fee but not the surgeon, the anesthesiologist or the lab work. Patients often learn the full cost only after the bills arrive, sometimes from several different offices.

A warning letter is not a lawsuit or a fine. But it puts companies on notice that the FTC is paying attention, and it gives patients a clear message: you are entitled to ask what your care will really cost.

What this means for your wallet

You don't have to wait for regulators to act. Here are steps that can help you avoid or fight surprise costs:

• Ask for the full price in writing. Before a planned procedure, ask the hospital or clinic for an estimate that includes facility fees, doctor fees, anesthesia, lab work and imaging. Ask directly: "Is anything not included?"
• If you're uninsured or paying yourself, ask for a "good faith estimate." Under the federal No Surprises Act, patients who are uninsured or choose not to use insurance can get a written good faith estimate before scheduled care.
• Know your dispute rights. According to CMS, if you're uninsured or self-pay and your bill is at least $400 more than your good faith estimate, you may be able to dispute it. The bill must be dated within the last 120 calendar days, and there's a $25 fee to start the process.
• If you have insurance, call your plan. Ask which providers are in network and what your share will be after your deductible, the amount you pay before insurance starts covering costs.
• Compare prices when you can. For non-emergency care like scans or lab tests, prices can vary widely between facilities in the same area.
• Report problems. The FTC asks people to report deceptive practices at ReportFraud.ftc.gov.

It also helps to keep a simple folder, paper or digital, with every estimate, bill and insurance statement for a procedure. That makes it much easier to spot errors and challenge a charge.

This article is for education only and is not financial advice. Everyone's situation is different.