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Legislative and Regulatory Update | Legal and Regulatory Compliance

Reminder: Price Posting Requirement Began Jan. 1

Legislative and Regulatory Update | Legal and Regulatory Compliance

Reminder: Price Posting Requirement Began Jan. 1

CMS reminds healthcare providers that the format for posting is the hospital’s choice, but the information must be “consumer-friendly” and must enable patients to understand their financial liabilities and compare charges for similar services across other hospitals. 

The standard charge listings must be updated each year. 


Despite false rumors of a possible grace period, the requirement to post a list of standard hospital charges via the Internet took effect on Jan. 1. The requirement, as stated in 42 U.S.C. section 300gg-18(e), reads:   

Each hospital operating within the United States shall for each year establish (and update) and make public (in accordance with guidelines developed by the Secretary) a list of the hospital’s standard charges for items and services provided by the hospital, including for diagnosis-related groups established under section 1394ww(d)(4) of this title.” 
[Note: 42 U.S.C. section 1394(d)(4) is section 1886(d)(4) of the Social Security Act.]

In the Aug. 17, 2018, issue of the Federal Register at page 41686 CMS reminded readers that the format for posting is the hospital’s choice, but the information must be “consumer-friendly” and must enable patients to understand what their financial liability might be and compare charges for similar services across other hospitals. Simply posting the entire chargemaster on the website would most likely not be satisfactory because further context for the information is necessary. 

Likewise, posting a PDF is not enough; the file format must be “machine readable” (i.e., a format that can be easily imported/read into a computer system [XML, CSV, etc.]). A PDF does not satisfy this definition because although it is digitally accessible it cannot be easily imported/read. 

Resources:

Compliant posting on the website of John Muir Medical Center, Walnut Creek, California. 

FAQs regarding the price transparency requirement: 


J. Stuart Showalter, JD, MFS, is a contributing editor for HFMA.

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J. Stuart Showalter

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