The Centers for Medicare & Medicaid Services (CMS) can require hospitals nationwide to publicly share charges they negotiate with payers, a federal court ruled Tuesday.
The field has prepared for this rule since last year, yet we’d hoped this burdensome mandate would be scrapped through a challenge from health care groups, including the American Hospital Association.
In other states lacking rate setting, this means five types of charges must be shared publicly, including gross charges and those negotiated with payers. In Maryland, the rule means hospitals must post standard charges in a searchable form. Also to be posted are prices for “shoppable services,” or those that can be scheduled in advance. All by January 1, 2121.
MHA is here to help you comply. We’ll take up this matter with our Technical Work Group to offer fieldwide guidance.
We also foresee deeper scrutiny of hospital costs in the wake of the COVID-19 crisis. Our advocacy on consumer cost exposure has been ongoing for some time. We have aimed to educate policymakers on your commitment both to affordability for patients and to preservation of a stable health system.
Maryland hospitals have long been pioneers in transparency, so patients have access to useful and accurate information about costs and quality. There already are multiple places in our state where consumers can obtain information about health costs—the Health Services Cost Review Commission, Maryland Health Care Commission, and your own hospitals.
We’ll keep you updated on the work of our member-led groups, to make sure transparency guidance makes sense for hospitals and gives patients practical information to make decisions about their care.