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Most Kansas hospitals comply with new price transparency rule

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Kimberly James | The Center Square contributor

(The Center Square) – A price transparency rule put into effect earlier this year requires that hospitals report the cost of services online, but not all hospitals have met compliance standards.

The rule requires that by Jan. 1, 2022, all hospitals operating in the United States must make available a list of their current standard charges via the internet in a machine-readable format at least annually, along with a list of 300 consumer-friendly “shoppable” services, of which CMS identifies 230.

"The most recent price transparency rules made changes to the definition of standard charges," Cindy Samuelson, senior vice president of member and public relations at Kansas Hospital Association, said.

"Instead of requiring hospitals to provide one charge, the definition of standard charge now includes gross charges, the discounted cash price, payer-specific negotiated charges for each third-party payer the hospital works with, and de-identified minimum and maximum charges negotiated with third-party payers. This expansion of the definition created a significant amount of work for hospitals."

This, Samuelson said, places a significant burden on hospitals, especially since they are still recovering from the impacts of the COVID-19 pandemic. Compliance is costly. Kansas hospitals are spending tens of thousands of dollars each year to comply with the new rules. Those expenses increase the cost of providing care.

"Sharing meaningful information with patients can be challenging because hospital care is specifically tailored to the needs of each patient," Samuelson said. "For example, a gall bladder operation for one patient may be relatively simple; however, for another patient, it could be fraught with unforeseen complications, making meaningful up-front pricing difficult and, perhaps, confusing for patients. Moreover, hospital prices do not include physician and other professionals' costs or, most importantly, how much of the cost a patient's insurance company may cover."

Most hospitals in Kansas have complied with the rule put in place by the Trump administration. Current penalties for hospitals that do not comply are about $300 per day, with harsher discipline expected to come in 2022.