Beginning Jan. 1, hospitals are required to post standard charges, including payer-specific negotiated rates, for 300 services online.
CMS issued a final rule in November 2019 that requires hospitals to disclose the rates they negotiate with insurers and hospital groups challenged the rule. In their 2019 lawsuit, the American Hospital Association, Association of American Medical Colleges, Children's Hospital Association and the Federation of American Hospitals said the price transparency rule will require hospitals to create files with hundreds to thousands of columns of negotiated rates. The lawsuit also states the file size could easily crash most standard computer systems, and some members worried about whether their websites would be able to function with the large file posted. The hospitals lost their appeal on Dec. 29.
Health systems in Michigan say they are prepared. Grand Rapids-based Spectrum Health told Fox 17 it has complied with the new regulations and will have prices for more than 450 services available on its website and through a price estimate tool on Epic's MyChart.
"The tool will calculate a price for the procedure that patients need, along with their deductible, copay and coinsurance, providing an accurate estimate of the price they will pay Spectrum Health," according to a statement provided to Fox 17.
The health system also said patients could call its financial services department to learn more about prices that aren't listed on the website.
Livonia-based Trinity Health and Grand Rapids-based Mercy Health also stated that its hospitals have data files published on their websites in compliance with the rule.