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New rules took effect July 1, including requiring hospitals to
affirm the inclusiveness, accuracy, and completeness of the
standard charge information. A third wave of requirements,
including new drug reporting and estimated allowed amounts, will
go into effect in January 2025.
“We all know about the hospital price transparency rules, the
mandates that require hospitals to post the negotiated rate,
that cash price, that list price for their services,” said Joe
Wisniewski, head of platform growth with Turquoise Health. “We
are now at this point where the goal posts have changed within
hospital price transparency rules.”
Turquoise Health is in the price transparency business. The
company has a patient-facing tool that can be used to search for
different prices and services based on distance to their home,
price, and quality.
Even though hospital price rules have been around for years,
some health care facilities have been slow to comply. The group
Patient Rights Advocate (PRA) released a report earlier this
year that showed only around 40% of Illinois hospitals they
investigated were compliant.
“They know the dollars and cents that they do charge, all this
is supposed to do by law is to allow all of us to be able to see
these prices,” said PRA CEO Cynthia Fisher.
The Centers for Medicare and Medicaid Services, which oversees
the implementation of the price transparency rule, has issued
approximately 1,200 warning notices to hospitals that have been
non-compliant.
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