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Hospitals Must Disclose Pricing

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Final CEE consent

November 25, 2019

Philips Comments on Medicare Payment Proposals

Hospitals—and perhaps insurance companies—will soon have to disclose the prices they charge for medical services, as a result of final and proposed rules by the Trump Administration.
  • Hospitals:
    The final rule requires hospitals to provide patients with clear information about standard charges for all items and services, including payer-specific negotiated charges and the amount the hospital is willing to accept in cash from a patient. The intent is to make it easier for consumers to shop and compare hospitals.  Also, hospital will have to disclose prices for 300 common services that consumers can schedule in advance, such as x-rays, outpatient visits, imaging, and laboratory tests. The final rule will require hospitals to make their standard charges public beginning in January 2021.

 

  • Insurance Companies:
    The proposed rule would require most employer-based group health plans and health insurance issuers offering group and individual coverage to disclose price and cost-sharing information for all covered health items and services. The goal is to give consumers an accurate estimate of out-of-pocket costs they must pay to meet their plan’s deductibles, co-pays, or co-insurance. Insurers would also have to disclose their negotiated rates for in-network providers and allowed amounts paid for out-of-network providers.