Search Results: "price transparency rule"
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Flawed design is why hospitals are not complying with price transparency rules
Experts believe CMS’ price transparency rule is flawed in its design because the highly complex billing data it is asking hospitals to post is too confusing for consumers to understand. The complicated structure of the healthcare system — from care variance to deductibles to billing codes — means that producing an accurate price estimate is virtually impossible. To improve compliance, hospitals will need health tech companies to step in.
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Hospitals, Consumer / Employer, Legal
Progress report: Vast majority of hospitals still aren’t following the price transparency rule
In its second report evaluating whether hospitals are with complying with the price transparency rule that went into effect Jan. 1, 2021, PatientRightsAdvocate.org found compliance to be still very low with none of the hospitals at the nation’s largest hospital system posting prices online.
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Insurer price transparency rule faces legal challenges: 4 takeaways
Two lawsuits, filed by the U.S. Chamber of Commerce and the Pharmaceutical Care Management Association, allege that portions of the price transparency rule governing insurers are unlawful and would drive up healthcare prices, contrary to the rule’s stated aim.
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Only 5% hospitals are compliant with price transparency rule. Here’s how they did it.
The hospitals that were found to be fully compliant with the federal price transparency rule had a few strategies in common, including picking the right technology partner and beginning their efforts early — in some cases before the rule was even proposed.
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CMS proposes fining hospitals up to $2M annually for not following price transparency rule
CMS’ latest proposed rule, which includes stringent penalties for hospitals that are found to be flouting the price transparency rule, comes on the heels of an analysis showing that a vast majority of hospitals are not in compliance with the regulation that went into effect on Jan. 1.
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CMS’ price transparency rule offers providers, payers a win, too
Patients are not the only ones who will benefit from the price transparency rule — providers and payers can also gain competitive advantages as a result of the regulation. These include being able to deepen relationships with patients and support payment contract negotiations.
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CMS proposes putting $2.5B into hospitals’ coffers, eliminating part of price transparency rule
CMS has released its proposed inpatient payment rule for fiscal year 2022, which includes a payment bump that could increase reimbursement for hospitals by $2.5 billion. Further, in a win for hospitals, the proposal aims to repeal a part of the price transparency rule related to Medicare Advantage plans.
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Analysis: Will hospital price transparency rule actually allow patients to shop for care?
Though the price transparency rule aims to make it easier for healthcare consumers to compare prices, there is a lack of standardization in how hospitals present the data, making it hard for consumers to shop around for care, a new analysis shows.
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Analysis: Most hospitals not complying with price transparency rule
The federal price transparency rule for hospitals went into effect Jan. 1, but a new analysis shows that a majority of providers studied were “unambiguously noncompliant.”
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Hospitals lose appeal to block CMS’ price transparency rule
A federal appeals court has ruled against hospital groups in their legal challenge to the CMS regulation that would require hospitals to make pricing information publicly available. The rule is set to take effect Jan. 1.
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Provider groups, hospitals file motion to stop CMS from enforcing price transparency rule
The American Hospital Association and several other entities, including some hospitals, filed an emergency motion to block CMS from enforcing the hospital price transparency rule set to take effect Jan. 1. Provider groups are arguing that complying with the rule would shift focus away from pandemic-related efforts.
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Price transparency rule finalized, but insurers say it will not rein in costs
The final rule requires insurers to disclose information on prices for healthcare services and cost-sharing with patients. The government says it will help lower prices, but insurers aren’t so sure.
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Court upholds new price transparency rules. What’s next?
A district court judge ruled in favor of the Department of Health and Human Services’ price transparency rule, which would require hospitals to disclose negotiated rates with insurers, among other things. The case will likely be appealed, but experts shared what could happen if the rule goes into effect.
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White House unveils finalized healthcare price transparency rule
Hospitals will soon have to share price information they have long kept obscured — including how big a discount they offer cash-paying patients and rates negotiated with insurers — under a rule finalized Friday by the Trump administration.
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Judge rules against hospitals in price transparency lawsuit
A federal judge ruled against the American Hospital Association and other hospital groups that challenged the Department of Health and Human Services’ new price transparency rules. AHA said it would appeal the decision.