Hospital price transparency rule takes effect

January 4, 2021
Keith A. Reynolds

The rule tasks hospitals with posting the pricing information online about the items and services they provide.

Hospitals can no longer keep the prices of various procedures and services they provide after the Trump administration’s price transparency rule took effect Jan. 1.

According to the Centers for Medicare & Medicaid Services (CMS) website, hospitals can do this in two ways: posting a comprehensive machine-readable file with all items and services or in a display of shoppable services in a patient-friendly format. The agency intends to audit a sample of hospitals starting this month as well as investigating complaints submitted by third parties.

The site says that hospitals that are not compliant may face civil monetary penalties.

The rule was opposed by the American Hospital Association (AHA) and other industry groups, which sued to block it from taking effect last year. That case was dismissed by a judge in June.

U.S. District Judge Carl Nichols said that rule is reasonably related to the government’s interest in lowering healthcare costs and providing pricing data in an attempt to allow patients to make informed decisions about their care, as previously reported.

The AHA said at the time that they intended to appeal the ruling. The appeal was denied on Dec. 29.

In a statement on the denial, the AHA voiced its disappointment in the ruling saying that the court’s unwillingness to grant a stay in enforcement of the rule “ignores the overwhelming burden of the pandemic on hospitals.”

“The AHA continues to believe that the disclosure of privately negotiated rates does nothing to help patients understand what they will actually pay for treatment and will create widespread confusion for them,” the statement says. “We also believe it will accelerate anticompetitive behavior among commercial health insurers and hinder innovations in value-based care delivery. Lastly, the requirement imposes significant costs on care providers at a time when scarce resources are needed to fight COVID-19 and save lives. For these reasons, the AHA has urged the incoming administration to evaluate whether the rule should be revised and to exercise enforcement discretion for the duration of the public health emergency.”