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Device-Related Procedure Costs To Be Revealed Under CMS Proposed Payment Rule

Executive Summary

US hospitals would have to reveal on a public website their standard charges and insurer-negotiated prices for a long list of device-related procedures, advanced imaging scans, and lab tests under a proposed Centers for Medicare and Medicaid Services rule released on 29 July.

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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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