Final rule on price transparency looms

hospital money
Hospitals are confident a CMS proposal to require them to post payer-negotiated rates online will be delayed and challenged in court. (Getty/PraewBlackWhile)

CMS will deliver a decision next month that could force hospitals to post payer-negotiated rates online for certain services by the beginning of 2020.

The agency included the requirement in its 2020 hospital payment rule, which must be finalized by Nov. 1 and goes into effect on Jan. 1, 2020. But some hospital leaders aren’t too worried about having two months to post their payer-negotiated prices in a searchable online format.

A recent survey of 161 hospital and health system leaders from consulting firm Advis found that 57% believe that any final rule will be challenged in court and be delayed. The survey also found that 44% weren’t doing anything to get ready for the new requirement until the final rule comes out.

RELATED: California passes legislation requiring Kaiser Permanente to reveal individual hospital pricing

Comments on the proposal gave a preview of the likely legal fight to come if the rule is finalized as proposed.

Hospital groups commented that CMS doesn’t have the constitutional authority to impose the rule, which would penalize hospitals $300 a day for noncompliance.

Hospitals are already required to post chargemaster, or list, prices online. However, CMS has been perturbed by the lack of compliance to the rule and concerned that the prices could be too confusing for consumers.

Either way, CMS will announce something (a delay or a final approval) by the end of the year.

Final rule on price transparency looms

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