Starting this year, hospitals across the country were mandated to disclose their rates for certain medical procedures as part of a new federal rule meant to bring a bit more transparency to the public health sector. But according to a new Wall Street Journal investigation, hundreds of hospitals nationwide have found a relatively sneaky way to keep the public from prying into their proprietary pricing data.
By digging into the backends for more than 3,000 sites belonging to hundreds of hospitals, the Journal found that the pricing disclosure pages for hundreds of them were embedded with a small bit of code meant to prevent the pricing disclosure page from getting surfaced on Google and other search engines. In total, per the report, the disclosure files for about 300 different hospitals were embedded with this chunk of code, though a little more than half—182—removed the snippet from their page after being contacted by the Journal.
To back up a bit, these new transparency rules ultimately stem back from a 2019 Executive Order signed by then-President Donald Trump that created a system for hospitals to disclose prices that insurers and patients pay for run-of-the-mill 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 uncovered by a healthcare-conscious consumer while they’re researching procedures online.
Aside from that, this data file needs to be displayed “prominently” on the hospital’s consumer-facing public website, and the hospital needs to ensure these pages “are easily accessible and without barriers.”
Good intentions aside, we’ve seen healthcare providers struggle to implement the new law due, in part, to how damn ambiguous it is. Past reports have pointed out that the vague requirements hoisted onto hospitals as part of these new rules often result in these pricing lists being difficult—if not downright—impossible to find, even if the lists are technically “machine-readable” and “on the internet.” Meanwhile, as the Journal points out, the order doesn’t specify exactly how much detail these hospitals are even supposed to offer on their pricing sheets—meaning that it’s up t0 the hospitals whether they want to include rates pertaining to specific health insurance plans, or whether they want to simply include different plan’s rates in aggregate.
Then there’s the new Journal report. The hospitals at the center of this new investigation—which included facilities owned by major names like HCA Healthcare and NYU Langone Health—were all found embedding a specific string of code meant to prevent their pricing page from being indexed by search engines.
This means that while the page technically exists online, there’s no way to surface it within search results, no matter the number of other sites that might link to it or the phrases that you plug into the search engine. The only way to find these pages, ultimately, is to crawl the sites on your own and see which pages might be flagged with the snippet of non-indexing code.
Three of the major hospital chains found using this snippet—including Penn Medicine and NYU Langone—told the Journal that they implemented it as a way to direct patients towards intel that might be more informative than a clump of raw pricing data. It’s a qualm that we’ve seen play out in court over the past year. When the Trump administration first tried to pass this new law, one of the reasons that major hospital groups ended up lobbing a lawsuit back at the administration was the argument that the rule would “generate confusion about patients’ financial obligations, not quell it.”
That said, it’s worth noting that some hospitals claim that not all of these search-blocking code snippets were left intentionally. In some cases after being contacted by the Journal, hospitals pulled the snippet from their site, saying it was a piece of “legacy code” that was no longer needed. Others said that the code was left on their website “in error.” In some cases, the code could’ve been left as the hospitals worked to tighten up these pricing pages as a way to prevent the drafted document from being indexed in search—and whoever was responsible for the page simply forgot to take the snippet off.