Seema Verma, Administrator of the Centers for Medicare and Medicaid Services (CMS), announces Medicare payment rule changes on Monday. Amid those changes was a proposed rule that would require all hospitals to publicly post their payer specific negotiated rates for at least 300 “shoppable” services along with their chargemaster prices online. The posting must include charges for services that the hospital customarily provides and their corresponding common billing code. The information must be updated on an annual basis. Those facilities and payers not willing to comply would face civil monetary penalties.
The new rule will most certainly boost competition among hospitals. Under the current rule, CMS and other beneficiaries pay more for services provided in a hospital outpatient setting than in a physician office setting. This proposed change would result in lower co-payments and over $800 million in savings for the Medicare program and taxpayers for 2020.
When asked if CMS was concerned about push-back and possible lawsuits by providers and payers, Verma responded, “This administration is not afraid of those things. We’re not about protecting the status quo when it doesn’t work for patients.” The CMS then went on to say that the proposed rule is the result of President Trump’s recent Executive Order on price and quality transparency, creating a more patient-centered healthcare system.
Comment submissions on the rule close out September 27th. If enacted, the rule would go into effect January 1, 2020.