Four takeaways about these efforts:
1. CMS included price transparency requirements in the 2020 Medicare Outpatient Prospective Payment System proposed rule. The rule, released July 29, would require hospitals to publish the rates they negotiate with payers for hundreds of services consumers are likely to shop for in a searchable and consumer-friendly manner.
2. In Congress, a bill to lower healthcare costs is also advancing. On June 26, the Senate health committee voted to advance the Lower Health Care Costs Act formally introduced by Senate health committee Chairman Lamar Alexander, R-Tenn., and health committee ranking member Sen. Patty Murray, D-Wash. The legislation, among other things, bans certain anticompetitive terms in contracts between heathcare facilities and health plans.
3. Major U.S. hospital groups have spoken out against price transparency requirements in the OPPS rule. They called the requirements “a misguided attempt to improve price transparency.” However, Senate health committee Chairman Lamar Alexander, R-Tenn., and HHS Secretary Alex Azar provided generally positive feedback. Additionally, Nashville, Tenn.-based HCA Healthcare said it is receptive to a rule from CMS and the competitive opportunities it could bring.
4. The Lower Health Care Costs Act and the CMS proposed rule are not final. The Lower Health Care Act needs approval by the full Senate and House. But Mr. Alexander said the legislation is “looking like a train that will get to the station when Congress reconvenes in September.” The federal government is accepting comments on the OPPS rule through Sept. 27.
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