US Insurers, Hospitals, Medtech Industry Say Transparency Rule Touted In President’s Speech Is Anticompetitive
Trump says transparency rule ‘bigger than health care reform’ while hospitals file suit against it
US President Donald Trump in his State of the Union address on 4 February touted his 2019 Price Transparency executive order calling on federal agencies to require private hospitals and insurers to publicly reveal the costs of hundreds of their device-related procedures and lab tests – as well as insurers’ negotiated rates for them – so patients can shop for their own health care. But industry maintains the resulting rules out of the Centers for Medicare and Medicaid Services are “anticompetitive,” and a coalition of hospital groups is suing the Department of Health and Human Services to stop their implementation.
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CMS Hospital Price Transparency Rule To Begin Public Reveal Of Device-Related Procedure Prices, Test Costs In 2021
The US Medicare agency on 15 November released a final cost transparency rule calling on hospitals to detail their standard “shoppable services” charges for X-rays, advanced imaging, laboratory tests and an array of other device-related procedures, beginning on 1 January 2021. Meanwhile, an accompanying proposed rule released by the CMS on the same day would require insurance health plans to provide to participants and beneficiaries the insurers’ negotiated rates for all covered health-care items and services.
AdvaMed Pans CMS Plan To Mandate Publicizing Hospital Rates, But Likes Pay Path For Breakthrough Devices
AdvaMed took issue with several aspects of a US Centers for Medicare and Medicaid Services (CMS) outpatient payment system draft rule mandating that hospitals publicize prices for their surgical procedures and laboratory tests, in comments on the draft. But the medtech industry advocacy group, as well as the Medical Device Manufacturers Association (MDMA), say they support another provision – the agency's new Medicare coverage and payment proposal for breakthrough devices – and requested only minor tweaks to the plan.