[{"innerBlocks":[],"name":"core\/freeform","postId":653,"blockType":{"name":"core\/freeform","keywords":[],"attributes":{"content":{"type":"string","source":"raw"},"lock":{"type":"object"}},"providesContext":[],"usesContext":[],"selectors":[],"supports":{"className":false,"customClassName":false,"reusable":false},"styles":[],"variations":[],"apiVersion":3,"title":"Classic","description":"Use the classic WordPress editor.","category":"text"},"originalContent":"The Centers for Medicare and Medicaid Services on Monday released a proposed payment rule that would require hospitals to make pricing information publicly available and transparent. \u201cWe are proposing to establish requirements for all hospitals in the United States for making hospital standard charges available to the public,\u201d states the Calendar Year 2020 Medicare Outpatient Prospective Payment System (OPPS) and Ambulatory Surgical Center (ASC) Payment System Proposed Rule, <\/b>which would go into effect Jan. 1, 2020.In the rule<\/a>, CMS defines \u201cstandard charges\u201d to include payer-specific negotiated rates\u2014as well as gross charges\u2014which are to be included in the list of standard charges for all items and services that hospitals are currently required to post online. Further, the agency\u2019s rule requires hospitals to publish the payer-specific negotiated charges for \u201ccommon shoppable services\u201d in a standardized, consumer-friendly manner. \u201cConsumer friendly means the hospital charge information must be made public in a prominent location online (or in written form upon request) that it is easily accessible, without barriers and searchable,\u201d according to CMS. \u201cIt also means the service descriptions are in \u2018plain language\u2019 and the shoppable service charges are displayed and grouped with charges for any ancillary services the hospital customarily provides with the primary shoppable service.\u201dThe agency also proposes new enforcement tools including monitoring, auditing, corrective action plans, as well as civil monetary penalties.According to CMS, the rule has been proposed as a direct result of President Trump\u2019s executive order on price and quality transparency issued last month.Also See<\/b>: Trump presidential order takes aim at price transparency"All Americans have the right to know the price of their healthcare up front,\u201d said CMS Administrator Seema Verma in a written statement. \u201cThanks to President Trump, healthcare prices won\u2019t be a mystery, and consumers will be able to shop for healthcare just like they do for everything else they buy. This rule will finally expose hospital pricing practices, let hospitals compete on price and is a first step toward ending surprise billing practices.\u201dNonetheless, the reaction to the CMS proposed rule from the American Hospital Association was swift and decidedly negative. While AHA said it supports price transparency, the industry group criticized the proposal for missing the mark, exceeding the Trump administration\u2019s legal authority, and it called for the rule to be abandoned.\u201cAmerica\u2019s hospitals and health systems are dedicated to ensuring patients have the information they need to make informed health care decisions, particularly knowing what their expected out-of-pocket costs will be,\u201d said AHA President and CEO Rick Pollack in a written statement. \u201cHowever, mandating the disclosure of negotiated rates between insurers and hospitals is the wrong approach. Instead, it could seriously limit the choices available to patients in the private market and fuel anticompetitive behavior among commercial health insurers in an already highly concentrated insurance industry.\u201dAsked during a call on Monday with members of the press whether the Trump administration is concerned about opposition to the rule from provider groups, who may take legal action to stop the publishing of prices under the rule, Verma replied that \u201cthis administration is not afraid of those things.\u201dThe CMS chief added that consumers want to shop around for certain types of healthcare services and that the administration is \u201cnot about protecting the status quo when it doesn\u2019t work for patients.\u201d","saveContent":"The Centers for Medicare and Medicaid Services on Monday released a proposed payment rule that would require hospitals to make pricing information publicly available and transparent. \u201cWe are proposing to establish requirements for all hospitals in the United States for making hospital standard charges available to the public,\u201d states the Calendar Year 2020 Medicare Outpatient Prospective Payment System (OPPS) and Ambulatory Surgical Center (ASC) Payment System Proposed Rule, <\/b>which would go into effect Jan. 1, 2020.In the rule<\/a>, CMS defines \u201cstandard charges\u201d to include payer-specific negotiated rates\u2014as well as gross charges\u2014which are to be included in the list of standard charges for all items and services that hospitals are currently required to post online. Further, the agency\u2019s rule requires hospitals to publish the payer-specific negotiated charges for \u201ccommon shoppable services\u201d in a standardized, consumer-friendly manner. \u201cConsumer friendly means the hospital charge information must be made public in a prominent location online (or in written form upon request) that it is easily accessible, without barriers and searchable,\u201d according to CMS. \u201cIt also means the service descriptions are in \u2018plain language\u2019 and the shoppable service charges are displayed and grouped with charges for any ancillary services the hospital customarily provides with the primary shoppable service.\u201dThe agency also proposes new enforcement tools including monitoring, auditing, corrective action plans, as well as civil monetary penalties.According to CMS, the rule has been proposed as a direct result of President Trump\u2019s executive order on price and quality transparency issued last month.Also See<\/b>: Trump presidential order takes aim at price transparency"All Americans have the right to know the price of their healthcare up front,\u201d said CMS Administrator Seema Verma in a written statement. \u201cThanks to President Trump, healthcare prices won\u2019t be a mystery, and consumers will be able to shop for healthcare just like they do for everything else they buy. This rule will finally expose hospital pricing practices, let hospitals compete on price and is a first step toward ending surprise billing practices.\u201dNonetheless, the reaction to the CMS proposed rule from the American Hospital Association was swift and decidedly negative. While AHA said it supports price transparency, the industry group criticized the proposal for missing the mark, exceeding the Trump administration\u2019s legal authority, and it called for the rule to be abandoned.\u201cAmerica\u2019s hospitals and health systems are dedicated to ensuring patients have the information they need to make informed health care decisions, particularly knowing what their expected out-of-pocket costs will be,\u201d said AHA President and CEO Rick Pollack in a written statement. \u201cHowever, mandating the disclosure of negotiated rates between insurers and hospitals is the wrong approach. Instead, it could seriously limit the choices available to patients in the private market and fuel anticompetitive behavior among commercial health insurers in an already highly concentrated insurance industry.\u201dAsked during a call on Monday with members of the press whether the Trump administration is concerned about opposition to the rule from provider groups, who may take legal action to stop the publishing of prices under the rule, Verma replied that \u201cthis administration is not afraid of those things.\u201dThe CMS chief added that consumers want to shop around for certain types of healthcare services and that the administration is \u201cnot about protecting the status quo when it doesn\u2019t work for patients.\u201d","order":0,"get_parent":{},"attributes":[],"attributesType":{"content":{"type":"string","source":"raw"},"lock":{"type":"object"}},"dynamicContent":""}]

CMS rule requires hospitals to make lists of standard charges public

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