Astronomical hospital bills are a trope of American health care. Hospitals in the US are known for charging exorbitant fees for simple procedures, and for adding baffling entries to discharge bills. Notorious examples include the woman who was charged $40 to hold her newborn, and the $18,000 emergency-rom bill that a family received after their baby was “treated” with some milk and a nap.
The surprise factor, at least, may soon be changing. On Jan. 1, a new regulation takes effect requiring hospitals to post the prices of their services online. Announced by health and human services secretary Alex Azar in April, the provision is called Inpatient Prospective Payment System rule. Under it, hospitals will have to share the prices of standard services online, as well as make medical records more easily accessible by patients themselves, and shareable between medical practices.
Though hospitals are already required to make their prices available in some form, and to allow patients to access their medical records, the new rule aims to simplify both and increase overall transparency. Starting next year, Medicare reimbursements will be based in part on the quality of an institution’s information-sharing and accessibility.
In April, Azar said he believed the regulation will enable market competition and bring down costs by putting “patients in charge of their care and [allowing] them to receive the quality and price information needed to drive competition and increase value.”
The idea that competition will take care of America’s health care costs has often been pushed by conservatives, but the new regulation does nothing to set or limit prices themselves. Patients will be hard pressed to discern whether a hospital’s price is fair, and listed prices won’t be indicative of what’s covered by insurance.
thenewsreviewonline on December 28th, 2018 at 00:30 UTC »
TL;DR: Effective January 1, 2019, Centers for Medicare & Medicaid Services (CMS) will require hospitals to make available a list of their current standard charges via the Internet in a machine readable format and to update this information at least annually, or more often as appropriate. This could be in the form of the chargemaster itself or another form of the hospital’s choice, as long as the information is in machine readable format. The Affordable Care Act 2015 included a requirement for all hospitals to establish, update and make public a list of the hospital’s “standard charges” for items and services provided by the hospital however the 2015 rule did not require them to do so via the internet as the new rule specifies.
CMS FAQ: https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/AcuteInpatientPPS/Downloads/FAQs-Req-Hospital-Public-List-Standard-Charges.pdf
CMS Rule (Bottom of Page 2136): https://s3.amazonaws.com/public-inspection.federalregister.gov/2018-16766.pdf (Last accessed 27th Dec 2018)
Eliju on December 27th, 2018 at 21:04 UTC »
I hope this helps somehow. The bigger issue is that providers each negotiate with insurance separately and those prices are way way lower than what you’d get charged going in with no insurance. And those negotiated prices are secret.
ArchDucky on December 27th, 2018 at 21:03 UTC »
Some lady was charged $40 to hold her own baby? Seriously?