Hospital groups challenge CMS’ price transparency rule, ask for expediated decision

Wednesday, December 4, 2019

The American Hospital Association (AHA) and other hospital groups filed a lawsuit December 4 challenging CMS’ Hospital Price Transparency Final Rule. The final rule, which was released November 15 and is effective January 1, 2021, expands on the price transparency requirements finalized in the 2019 inpatient prospective payment system (IPPS).

The suit argues that the final rule is unlawful because it exceeds CMS’ statutory authority. In the final rule, CMS said that it has the authority to require disclosure of payer-specific negotiated charges to fulfill a statutory provision of the Affordable Care Act that mandates hospitals publish their standard charges for items and services. The suit contends that the final rule oversteps the AHA’s requirements because negotiated charges are not the same as standard charges. In addition, the suit alleges that the final rule violates the First Amendment because it compels speech and does so in a manner that “does not directly advance a substantial government interest.”

The suit also argues that the final rule is arbitrary and capricious, lacks any rational basis, and that CMS’ explanation for the final rule is illogical and is not supported by evidence.

The groups are filing an early motion for summary judgment and are asking for an expediated decisionso that hospitals do not need to spend time and resources preparing to comply with the final rule.

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