Hospitals Now Required to Disclose Negotiated Prices

On June 23, 2020, District Judge Carl Nichols ruled in favor of the Trump administration’s final rule requiring hospitals to disclose their negotiated prices.

This decision comes after a lawsuit filed by the American Hospital Association (AHA) late last year. The suit was an attempt to block the rule’s implementation, stating that the requirement to disclose negotiated prices violated their First Amendment rights.

The Final Rule

Effective January 1, 2021, hospitals will be required to provide easily accessible billing information to patients.

All standard charges, including “gross charges, payer-specific negotiated charges, the amount the hospital is willing to accept in cash from a patient, and the minimum and the maximum negotiated charges,” will need to be available online and in one single data file that can be read by other computer systems.

“American patients deserve to be in control of their healthcare. Especially when patients are seeking needed care during a public health emergency, it is more important than ever that they have ready access to the actual prices of healthcare services.”

Alex Azar, HHS Secretary

The rule is intended to make healthcare price information accessible to consumers and other stakeholders, allowing for both easy comparison-shopping and rate transparency. It also grants the Centers for Medicare & Medicaid Services (CMS) more authority over enforcement, which equates to greater capability to audit hospitals and issue fines to those who are non-compliant.

Hospital groups responded by saying that requiring access to such information “will confuse patients and unduly burden hospitals.”

From now until the time the rule becomes effective in January 2021, hospitals will be working to make the applicable data available online if it is not already. The AHA is expected to appeal the ruling, which could potentially delay the rule’s effective date.

For more information regarding the rule, click here.


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