New Proposed Rule: Hospitals Publish Retail Prices

In July, the Centers for Medicare and Medicaid (CMS) proposed rules that would require all Medicare-participating hospitals to post their negotiated prices for standard health care services.

The proposed rule is intended to increase pricing transparency and help consumers understand the charges they may incur before receiving care. These are just proposed rules at the moment, which means no changes will be made effective until the rules are finalized.

“The proposed polices in the CY 2020 OPPS/ASC Payment System proposed rule would further advance the agency’s commitment to increasing price transparency, (including proposals for requirements that would apply to each hospital operating in the United States), strengthening Medicare, rethinking rural health, unleashing innovation, reducing provider burden, and strengthening program integrity so that hospitals and ambulatory surgical centers can operate with better flexibility and patients have what they need to become active healthcare consumers. 

This fact sheet discusses the major provisions of the proposed rule. The deadline for submitting comments on the proposed rule is September 27, 2019. The proposed rule (CMS-1717-P) can be downloaded from the Federal Register at: https://www.federalregister.gov/public-inspection.”

“Hospitals would be required to make public all hospital standard charges for all items and services provided by the hospital in a digital and machine-readable file posted online. Additionally, we propose that hospitals make public the payer-specific negotiated charge for a limited set of ‘shoppable’ services that are displayed and packaged in a consumer-friendly manner.”

Read more here.