CMS replies on price transparency rule

Posted on: 11/14/18

Hospitals asked many questions about the 2019 price transparency rule during a CMS Open Door Forum conference call on Nov. 13. One answer was given repeatedly, as Don Thompson of the Centers for Medicare & Medicaid Services (CMS) said the requirement applies to “all items and services provided by the hospital.”  

The rule requires all hospitals, effective Jan. 1, 2019, to “make available a list of their current standard charges via the internet in a machine readable format and to update this information at least annually, or more often as appropriate.”

Thompson said summaries of price averages or ranges for diagnosis related groups (DRGs) are not sufficient. However, hospitals were encouraged to provide additional information and context that would be beneficial to the patient. He also said that publishing chargemaster information is not the end goal of CMS, implying that additional information will be required in future years.

It is unclear how CMS expects hospitals to report prices for items priced variably, based on acquisition cost. During the Open Door Forum, a hospital raising this question was asked to submit the question by email. Thompson said CMS is considering adding to the Questions & Answers they’ve already posted.

In response to a question about penalties for noncompliance, Thompson said CMS is exploring enforcement mechanisms.
A recording of the Open Door Forum call is available for 48 hours after the Tuesday call at 1-855-859-2056; Conference ID: 35530114.

Earlier: “Hospitals question CMS price transparency rule,” OHA Hotline, Oct. 3, 2018; includes a link to CMS Questions & Answers on the requirement. (Rick Snyder)