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Court hears oral arguments in price transparency lawsuit

Providers need time to implement the final rule, scheduled to go in effect Jan. 1, 2021, at a time when they are facing the coronavirus pandemic.

Susan Morse, Managing Editor

The American Hospital Association and six other provider groups and health systems have asked the U.S. District Court to throw out a final rule requiring them to publicly post their negotiated prices with insurers.

On May 7, through video conference, Judge Carl J. Nichols of the U.S. District Court for the District of Columbia, heard oral arguments on motions for summary judgments requested by both the AHA and plaintiffs and the defendant, the Department of Health and Human Services.

WHY THIS MATTERS

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The final rule is scheduled to go into effect on Jan. 1, 2021.

Time is of the essence, the plaintiffs said in requesting a video conference after the court postponed an April 22 hearing, presumably because of the pandemic.

Providers said they needed time to prepare to implement the rule at a time when they are dealing with the coronavirus pandemic and its resulting financial issues.

They wrote on April 22: "We appreciate the extraordinary constraints under which the courts are currently operating because of the COVID-19 pandemic. At the same time, hospitals have not been relieved of the January 1, 2021 deadline to comply with the Administration's new negotiated charge disclosure requirements  a deadline that was difficult even before the nation's hospitals have been put under the unimaginable strain of the current pandemic. The new CMS rule increases the financial strain on hospitals nationwide, many of which are already at the financial breaking point due to the present public health crisis."

THE LARGER TREND

The Centers for Medicare and Medicaid Services released the final rule in November 2019. The plaintiffs brought their lawsuit that December.

The rule will accelerate anticompetitive behavior among health insurers and stymie innovations in value-based care delivery, the groups said. Instead of helping patients know their out-of-pocket costs, the rule will introduce widespread confusion.

HHS has overstepped its authority in releasing the rule, they said.

Twitter: @SusanJMorse
Email the writer: susan.morse@himssmedia.com