"This final regulation on hospital transparency fails to meet the definition of ‘price transparency useful for patients,’” Chip Kahn, president and CEO of FAH, said in a written statement. Within a couple hours of the rule release, the Federation of American Hospitals (FAH) promised to join individual hospitals in suing to stop implementation of the new requirements on the basis that CMS lacks the authority to establish them.
Removing the separate requirement to list all associated ancillary services.Modifying the data elements of standard charges that hospitals must publicize.Allowing hospitals that do not provide 300 services that can be scheduled by consumers in advance to list as many such services as it provides.Modifying the definition of shoppable services to remove reference to a “service package”.Modifying definitions for the de-identified minimum negotiated charge and the de-identified maximum negotiated charge.The final rule included some changes from the proposed rule, most significantly delaying implementation of the new requirements until Jan. The judge’s decision can be reviewed by the CMS administrator. The rule also established a process for hospitals to request a hearing before an administrative law judge to appeal the civil monetary penalty. The posted rates must include charges for services that the hospital customarily provides in conjunction with a primary service that is identified by a common billing code.ĬMS will deem a hospital compliant with the new requirements if the hospital maintains an Internet-based price estimator tool that meets specified requirements, including real-time estimates for consumers on their costs for a shoppable service offered by the hospital.įailure to comply with the requirements could lead CMS to impose fines of up $300 per day (totaling $109,500 annually) and to publicize a hospital’s lack of compliance on its website. “CMS believes these requirements will allow healthcare consumers to make apples-to-apples comparisons of payer-specific negotiated charges across healthcare settings,” a CMS fact sheet stated. This information must be made available in a consumer‑friendly manner.
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Ensuring the data is easily accessible, without barriers, is free and does not require an account or password or for a user to submit personal informationĪdditionally, hospitals must post online their standard charges for at least 300 “shoppable services” (including 70 CMS-specified and 230 hospital-selected) that the hospital provides.
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