The Centers for Medicare & Medicaid Services (CMS) will implement hospital transparency rules on January 1, 2021. The agency has released a final rule,[1] guidance,[2] and answers to frequently asked questions[3] to help hospitals get compliant with the new rule. Additional resources are available on the agency’s dedicated page.
The new rule requires hospitals to provide pricing information in a machine-readable format that provides easy access for consumers both online and offline. CMS stated on its site that it would be enforcing the new rules effective January 1. Enforcement may include a warning notice, a corrective action plan, or a civil monetary penalty and publication of
“Because the Hospital Price Transparency Final Rule focuses on charge data that is controlled by providers, specifically hospitals, we view these policies as a first step in ensuring that pricing data necessary to determine out-of-pocket costs is available to consumers,” CMS stated in an answer to one of the frequently asked questions.[5] “We continue to encourage hospitals to go further in helping individuals understand their financial obligations in advance of receiving a health care service by, for example, creating consumer-friendly price transparency tools and lookups that provide consumer-specific out-of-pocket price estimates.”