CMS 2019 IPPS final rule transparency requirement

November 28, 2018

The Centers for Medicare and Medicaid Services  (CMS) has introduced a new requirement for all hospitals regarding transparency and posting of standard charges as reflected in the chargemaster, effective Jan. 1, 2019. The requirement applies to all hospitals.

The 2019 IPPS final rule requires “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.” The rule provides guidelines for an existing requirement from the Public Health Service Act.

The rule was finalized despite letters from the American Hospital Association , WSHA and other state hospital associations. The associations commented that charge information would be of little benefit and would be confusing to consumers as it would not reflect their out-of-pocket costs. Despite these concerns, CMS is requiring hospitals to provide information for all items and services provided by the hospital based on the chargemaster.

CMS is not expected to provide significant additional guidance prior to the start date. WSHA recommends hospitals make efforts to comply with the requirements as they are currently known and has further details on this requirement available in an online bulletin. WSHA will continue to engage with CMS to offer feedback and gain clarification on the new guidelines and other federal price transparency efforts.

Hospitals can review the CMS Frequently Asked Questions (FAQs) for additional information, and should consult with their legal counsel to make decisions regarding how best to comply with the requirements.


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