In May 2013, Mt. Sinai Medical Center CEO Steve Sonenreich promised on WLRN's Sunshine Economy to make public the contracted reimbursement rates his hospital receives from insurance companies. He didn't know his facility already had agreed to keep those prices secret.
Sonenreich now says he was unaware of non-disclosure agreements Mt. Sinai Medical Center has with insurance companies regarding those contracted prices.
"When I made the pledge, obviously I intended to post our rates," Sonenreich said on Monday's Sunshine Economy. "[I] got back to the hospital, met with our executive management staff and found out that our contracts with various insurance companies precludes us from releasing that information."
Sixteen months ago, Sonenreich pledged to do just that. On the Sunshine Economy he said, "We will post our prices relative to Blue Cross and Aetna -- our contracted prices."
But he now says those prices have to remain secret because of the legal agreements he says are customary in the business between health care facilities and health care insurance carriers. "It's the only way to conduct business in this community."
The contracted rates are the prices health care providers and insurance companies privately negotiate. They are the rates the insurance company agrees to pay the provider if it provides care to a patient covered by the insurance. However, the patient is not directly informed about these contracted prices, as WLRN-Miami Herald and the Miami Herald explored in its series Power of Price. These negotiated rates may show up on an insured patient's explanation of benefits but the patient is not aware of this portion of the cost prior to treatment.