New Rules on Price Transparency Announced

Posted on November 22, 2019

The Centers for Medicare & Medicaid Services unveiled two major transparency policies for hospitals and insurers Nov. 15.

Under a final rule, hospitals will be required to make their “standard charges” public in a comprehensive machine-readable file and in a display of shoppable services in a consumer-friendly manner starting in 2021.

In a separate proposed rule, insurers would be required to give consumers real-time, personalized access to cost-sharing information, including an estimate of their cost-sharing liability for all covered healthcare items and services, through an online tool. They must also disclose on a public website their negotiated rates for in-network providers and allowed amounts paid for out-of-network providers.

The American Hospital Association has issued a joint statement with the Association of American Medical Colleges, the Children’s Hospital Association and the Federation of American Hospitals opposing this move. The MHA will keep members updated on legal challenges to the new rules, as referenced in the statement.

Michigan hospitals are committed to increased transparency around healthcare quality and costs, including price information for patients. Hospitals voluntarily share quality data on VerifyMICare.org, which was recently updated to add new measures about patient experience to better convey the quality of care in Michigan hospitals.

The association recognizes the significant amount of administrative work these rules require and will develop resources to assist members with compliance, should the rules take effect as planned in 2021. Additional information was emailed to members Nov. 19, and members with questions may contact Jason Jorkasky at the MHA.

 



Tags: AHA, CMS, VerifyMICare, price transparency, Jason Jorkasky

Posted in: Issues in Healthcare, Member News

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