Summary
The attached memorandum provides a detailed overview of the proposed price transparency requirements included in the Calendar Year (CY) 2020 hospital outpatient prospective payment system (OPPS) proposed rule. Pursuant to a recent Executive Order, the Centers for Medicare & Medicaid Services (CMS) used the rule as a vehicle to advance regulatory changes designed to drive down hospital costs by making price information publicly available and accessible for consumers.
The memo discusses the parameters – including specified data elements, file formats, and update frequencies – of the two distinct and newly defined proposed requirements in the CY 2020 OPPS proposed rule, namely:
- Existing hospital charge display requirements for all items and services must now encompass charges and information based on payer-specific negotiated rates; and
- For up to 300 self-selected common “shoppable” items and services, hospitals must display payer-specific negotiated charges in a manner that is consumer-friendly and that includes costs for associated ancillary items and services that the hospital provides with the shoppable service.