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CMS warns hospitals not following value transparency guidelines

CMS is sending warning letters to hospitals breaking new federal guidelines requiring them to make public the costs they negotiate with insurers, a CMS spokesperson confirmed.

The regulation took impact on Jan. 1 and forces hospitals to publish a machine-readable file on-line containing their payer-negotiated charges. It additionally requires them to make accessible a consumer-friendly show of at the least 300 shoppable companies, together with 70 specified by CMS. However hospitals need not publish an inventory of shoppable companies if they permit customers to make use of a value estimator software to calculate their out-of-pocket prices for all shoppable companies.

However round two-thirds of the nation’s largest hospitals will not be complying with the brand new value transparency rules, a Well being Affairs research present in March. Greater than 50 hospitals both didn’t embrace the payer-specific negotiated charges with the payer’s title and plan or had been non-compliant in another

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