After the publication of the Outpatient Prospective Payment System (OPPS) on Friday, the Trump Administration is holding off on a controversial transparency rule that would require hospitals to publicly post all privately negotiated payer rates. The Centers for Medicare and Medicaid Services (CMS) has promised to issue a “forthcoming final rule” related to the proposal that garnered 1,400 public comments.
Final rules regarding physician reimbursements and site neutral payments were released last week as part of the OPPS, but the July proposal demanding that Medicare participating hospitals publish the prices they agree upon with insurers for standard services was postponed. The rule was to go into effect on Jan. 1, 2020 in an effort to boost healthcare transparency.
The agency received more than 1,400 stakeholder comments on the provision, “We considered the thoughtful and innovative ideas provided during the comment period as we work to finalize the hospital price transparency rule alongside a comprehensive proposal for health plan price transparency,” CMS Administrator Seema Verma said in a statement.
Critics of the provision argue that the prices have no context to consumers or can be misconstrued given the complexity of the system. According to ModernHealthcare, comments to the agency made by providers claimed the disclosures would violate their First Amendment rights to free speech.
The administration’s goal was to drive down healthcare costs by creating more competition in the marketplace with published prices, as well as boost transparency.
Despite the win for hospitals and payers, American Hospital Association (AHA) Executive Vice President Tom Nickels issued a statement going after two other provisions CMS went ahead and finalized although being previously blocked by courts.
For a quick summary of the proposal, read this Axios piece.