CMS Tells Hospitals To Post Chargemasters Amid Doubts the Raw Data Is Useful to Patients

Adventist Health System was planning to comply with CMS’s hospital price transparency requirement by posting information about the most common procedures and customizing it for patients, at their request and according to their payers. That seemed like a meaningful way to achieve the transparency goals that originated in the Affordable Care Act and were expanded in the 2019 inpatient prospective payment system (IPPS) regulation, which took effect Oct. 1, says Nancy Hayt, vice president of corporate responsibility at the Florida-based health care organization.

But CMS has something more in mind. In new answers to frequently asked questions (FAQs) about the price transparency mandate, CMS said hospitals must post their chargemaster, which is a master list of prices of goods and services. The FAQs make this point by stating “the current requirements apply to all items and services provided by the hospital.”

That was a jolt to Adventist Health System and other hospitals. “We had talked about posting prices for only the most common procedures, but they have made it clear they don’t want only your most common procedures,” Hayt says. It doesn’t mean, however, hospitals can’t add value to the chargemaster requirement, and Adventist is moving in that direction. The IT department is developing a tool that will let patients calculate their out-of-pocket costs based on their procedure and insurer. But it will also have to post the entire chargemaster at CMS’s insistence.

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