Lexology December 6, 2019
The Centers for Medicare & Medicaid Services (“CMS”) recently issued a final rule requiring hospitals to publicly disclose their rates, including negotiated rates with third-party payors regardless of product line, by January 1, 2021 (“Final Rule”).[1] The Final Rule’s intent is to increase price transparency so that health care consumers can “shop” for health care services. The Final Rule does not exclude any particular type of health plan, product, or line of business, except for rates that are not negotiated (e.g., fee-for-service Medicare or Medicaid).
Hospitals that are deemed non-compliant are subject to fines of up to $300 per day, up to a maximum of $109,500 per year.
The Final Rule has been subject to pushback from hospitals. Most notably,...
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