CHA News Article

Ruling Requires Hospitals to Reveal Negotiated Rates
For CEOs, CFOs, COOs, government relations staff

A federal judge on Tuesday ruled that the Department of Health and Human Services can require hospitals to reveal the prices they negotiate with insurers. As required by the Hospital Price Transparency final rule – effective Jan. 1, 2021 – hospitals will be required to post gross charges, payer-specific negotiated rates, the de-identified minimum and maximum negotiated rates, and the cash discount price for all items and services on a website in a machine-readable format. In addition, the final rule requires posting of information for 300 “shoppable” services in a consumer-friendly manner.

The American Hospital Association (AHA) had sued to block the price transparency requirement. Although U.S. District Court Judge Carl Nichols’ ruling was a summary judgment, it can be appealed. The AHA had argued that forcing hospitals to publish their negotiated rates with insurers is a violation of the First Amendment and goes beyond the statutory intent of the Affordable Care Act.

President Trump issued an executive order last year instructing federal agencies to take a number of steps to promote price transparency and high-quality care, including a requirement that hospitals post standard charge information.

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