New Hospital Price Transparency: Disclosure of Standard Charges, Negotiated Rates, Implications for Other Obligations

This program has been cancelled

A live 90-minute CLE webinar with interactive Q&A


Thursday, March 12, 2020

1:00pm-2:30pm EDT, 10:00am-11:30am PDT


This CLE webinar will guide healthcare counsel on the new CMS hospital price transparency rule. The panel will examine the rule and its requirements. The panel will also discuss the implications of the rule on a hospital's relationship with insurers and patients as well as other legal obligations the hospital has. The panel will offer best practices for compliance with the new rule.

Description

On Nov. 15, 2019, CMS issued its final rule regarding the public disclosure of payment rates that hospitals have negotiated with commercial payers. The rule is effective on Jan. 1, 2021. The rule applies to all state-licensed hospitals. Federally operated hospitals are exempt.

Under the new rule, hospitals must disclose their standard charges for all the items and services they provide. This includes procedures, facility fees, room costs, and services by both physician and non-physician practitioners who are employed by the hospital. Hospitals must also disclose the negotiated rates with payers.

Hospitals that fail to comply with the transparency requirements will face civil monetary penalties and publication of these penalties on the CMS website. Healthcare counsel should consider the legal and other risks as they work with hospitals to comply with the new rule.

Listen as our authoritative panel of healthcare attorneys examines the new rule and its requirements as well as examine state regulations. The panel will discuss how the rule will impact hospitals, insurers and patients and their respective relationships, and offer guidance on steps for compliance.

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Outline

  1. New hospital price transparency rule
    1. Requirements
    2. Items and services
    3. Gross charges and payer-specific negotiated charges
  2. Implications of the rule on other legal obligations
    1. Antitrust considerations (price fixing, collusion)
    2. Medicare compliance
  3. Implications for relationships with insurers, patients
  4. Compliance best practices

Benefits

The panel will review these and other essential questions:

  • How much rate information must be disclosed?
  • What are the implications of the transparency rule for a hospital's relationship with payers?
  • What impact will the new rule have on other legal obligations? What antitrust considerations should counsel keep in mind?

Faculty

Burris, R. Ross
R. Ross Burris, III

Shareholder
Polsinelli

Mr. Burris applies a strong business acumen to understanding the goals and challenges clients face, and by leveraging a...  |  Read More

Parikh, Harsh
Harsh P. Parikh

Attorney
Nixon Peabody

Mr. Parikh works with managed care organizations, hospital systems, and other providers on a wide range of regulatory,...  |  Read More