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CMS delays rule requiring hospitals to post negotiated prices

A rule on hospital prices will be coming out alongside a proposal for health plan transparency, CMS Administrator Seema Verma says.

Susan Morse, Senior Editor

The Centers for Medicare and Medicaid Services is delaying its proposed rule requiring hospitals to post their standard prices based on their negotiated contracts with insurers.

CMS Administrator Seema Verma indicated in a tweet that a rule on price transparency would be coming out alongside a comprehensive proposal for health plan transparency.

"We received over 1,400 comments on our proposed requirements for hospitals to make public their standard charges. We intend to summarize and respond to public comments on the proposed policies in a forthcoming final rule," CMS said in a brief statement in Section XVI in its outpatient prospective payment system rule released last Friday.  "In addition, to inform our future efforts to develop policies related to transparency in healthcare charges, we published a Request for Information that sought stakeholder input on a number of related quality of healthcare issues. We received over 63 comments. We appreciate the feedback we received and will take it into account as we further consider our future policies."

Administrator Seema Verma tweeted, "We considered the thoughtful and innovative ideas provided during the comment period as we work to finalize the hospital price transparency rule alongside a comprehensive proposal for health plan price transparency. Taken together these two historic actions from the President's executive order will help Americans improve how they make critical, sometimes lifesaving decisions, about their healthcare."

WHY THIS MATTERS

Providers and payers oppose the rule that would reveal private negotiations in competitive contracts. It would require all hospitals to post payer-specific negotiated charges for certain non-urgent services in a user-friendly format.

If the rule is released as proposed, stakeholders are expected to sue to block it from being implemented.

THE LARGER TREND

The OPPS rule included a site neutral payment rule that would slash what is paid to offsite hospital outpatient departments. It also included cuts in the 340B drug program. Both of these were challenged and won by stakeholders in court.

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