Blog | Transparency

U.S. District judge hears CMS price transparency lawsuit opening arguments

Blog | Transparency

U.S. District judge hears CMS price transparency lawsuit opening arguments

  • CMS’s controversial price transparency policy is the subject of a lawsuit filed against the administration by the AHA and several providers.
  • Modern Healthcare reported that an attorney for the plaintiff argued before the U.S. District Court for the District of Columbia May 7 that lawmakers only allowed the federal government to make hospitals post a list of so-called “standard charges” and the rates they charge for diagnostic-related groups.
  • The attorney argued further that negotiated rates, by their nature, cannot be standard charges because they are the result of private negotiations, according to Modern Healthcare.

With everything else going on it might be easy to forget about CMS’s controversial price transparency policy, which is the subject of a lawsuit filed against the administration by the AHA and several providers.

According to an article in Modern Healthcare, an attorney for the plaintiff during the May 7 hearing argued that, “Lawmakers only allowed the federal government to make hospitals post a list of so-called ‘standard charges' and the rates they charge for diagnostic-related groups."

Modern Healthcare reported the same attorney argued that negotiated rates, by their nature, cannot be standard charges because they are the result of private negotiations.

The administration countered, in the article, that "hospitals' interpretation of federal law is misguided because it wouldn't make sense for Congress only to allow the agency to force hospitals to post their chargemaster lists and rates for diagnostic-related groups, especially since the latter can vary significantly by patient.”

Lawyers for the administration also used arguments providers used to push back against CMS’s original requirement that hospitals post their chargemasters stating that the data in the chargemaster for most consumers is meaningless. This they believe justifies the administration’s expanded definition of “standard charges,” which includes negotiated rates.  

Takeaway

Politico reported that the federal judge hearing the case appeared to side in his questioning with the administration. Obviously, it’s hard to tell how the judge will rule based on questioning at argument. And this is just the opening act in what will likely be a long series of appeals. 

About the Author

Chad Mulvany, FHFMA,

is director, healthcare finance policy, strategy and development, HFMA’s Washington, D.C., office.

 

 

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