Expanded price transparency requirements are set to become reality for hospitals effective January 1, 2021. On November 15, CMS released a final rule that pushed ahead with many of the requirements originally included in the 2020 OPPS proposed rule.
CMS is moving forward with multiple policies—effectively based on reducing reimbursement to hospitals—that have been deemed unlawful in court, according to the 2020 OPPS final rule, released Friday, November 1.
Q: Our new EHR system was built using logic for therapy charging based on both the AMA and CMS eight-minute rules. Charges will generate differently based on the payer. How do others implement the eight-minute rules? How do you think using two charging methodologies in this world of price transparency will look?
Q: We are in the middle of changing the hospital methodology for charging cardiac cath procedures within Epic CUPID. What is your hospital’s workflow for charging cardiac cath procedures?
CMS’ proposal mandating the disclosure of negotiated charges between hospitals and payers may exceed the agency’s legal authority and would have limited benefit to patients, according to the AHA.
