HOSPITALS REQUIRED TO POST STANDARD CHARGE LISTS (PRICES) IN DOWNLOADABLE FORMAT BY JANUARY 1, 2019

            Effective January 1, 2019, all hospitals operating in the United States, including psychiatric hospitals, community hospitals, and rehabilitation hospitals, will be required to post their standard charge lists (prices) for all services on-line in a downloadable format. Under the Affordable Care Act, hospitals had been required to make their standard charge lists publically available. The new rules require hospitals to go one step further by posting them on-line.

            The new rules require posting of standard charges for all services, including diagnosis related groups (DRGS), drugs and biologics. In addition, the rules require that the posts be in a “machine readable” format, which CMS defines as a digitally accessible format that can be easily imported into a computer system. Thus, hospitals can post their standard charges using XML or CSV formats, but PDFs are not permissible. There are no exemptions, meaning that even hospitals which participate in a state transparency initiative are not exempt from the federal requirement to post charges.

            In announcing the rules, CMS stated that it was part of its effort to empower patients through increased price transparency. Many hospitals have expressed concern that posting their standard charges will only confuse patients because health insurers generally pay hospitals at rates lower than standard charges and patients responsible for paying for their own care may qualify for charity care or other discounts.