Most big US hospitals are defying price disclosure rule

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Most of the largest U.S. hospitals are not in compliance with the CMS rule on hospital price transparency that went into effect Jan. 1, according to a blog post published March 16 in Health Affairs

The rule requires hospitals to make public "a machine-readable file containing a list of all standard charges for all items and services." To comply with the rule, hospitals' files must contain gross charges, discount cash prices, payer-specific negotiated charges, deidentified minimum and maximum charges and descriptions of and codes for the services and items provided by hospitals. 

Sixty-five of the 100 largest U.S. hospitals, based on bed count, were not in compliance with the rule, according to price transparency files collected from late January to early February. Twelve of the 65 noncompliant hospitals didn't post any files or provide links to searchable databases that were not downloadable. The rest of the noncompliant hospitals either did not include payer-specific negotiated rates with the name of the payer and plan clearly associated with the charges or were in some other way noncompliant. 

Of the remaining 35 hospitals, 22 appeared to be compliant with the rule based on the price transparency files, and some exceeded the regulation's requirements in terms of the amount of information they shared. 

There were some challenges to assessing compliance with the rule, including that it isn't always possible to compare a publicly posted standard charge file to a chargemaster to check that all of the elements of the file are contained in the chargemaster. 

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