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CMS Releases New Sample Formats to Assist Hospitals With Price Transparency Compliance

In an effort to ease achieving compliance with its newly instituted Hospital Price Transparency Rule, the Centers for Medicare & Medicaid Services (CMS) has recently published three sample formats on its website for hospitals to use as models.

The mandate, which went into effect in early 2021, requires hospitals to publish their standard charges for particular health care services in two ways: (1) a machine-readable file with all their items and services and (2) a display of their “shoppable services” in a “consumer-friendly format.” CMS believes that the new mandate will promote value-based health care by ensuring patients have access to quality and cost information. The hospital transparency mandate comes in the wake of similar efforts, such as the Transparency in Coverage Rule and No Surprises Act for insurers. You can view prior Steptoe & Johnson client alerts on Hospital Pricing Transparency here and here.

CMS has already begun auditing hospitals for compliance. In order to help with this process, CMS released the three sample formats — XML, JSON, and CSV — so that they can be “machine-readable.” The samples also contain the data elements that are required under the new rule. Current data suggests that around two-thirds of hospitals are in compliance with the rule, up from around 16% earlier in 2022. The sample formats from CMS can be accessed here.

Justin M. Wilson also contributed to this article.

© Steptoe & Johnson PLLC. All Rights Reserved.National Law Review, Volume XII, Number 341
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About this Author

Charles A. Sinsel, Steptoe Johnson, Corporate Transactions Lawyer, Employment recruitment Attorney
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Charles "Chark" Sinsel concentrates his practice in the areas of health care, corporate law, business transactions, and contracting. Mr. Sinsel represents health care entities, including hospitals, nursing homes, behavioral health providers, medical and dental practices, in a variety of transactions, including acquisitions, corporate restructuring, leasing, employment, recruitment, income guarantees, independent contractor (services) arrangements and group purchasing arrangements. Mr. Sinsel serves as leader of the Firm's Health Care Team.

 

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Kristen Wilson Steptoe Johnson Law Firm Wheeling, WV Professional Liability Litigation Attorney
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Clients know that Kristen Andrews Wilson will help them understand and navigate the complex and complicated healthcare landscape.  Kristen’s clients include hospitals, nursing homes, and long-term care facilities, as well as independent healthcare providers.  Kristen’s practice is a unique combination of litigation avoidance via counseling and defense via litigation, when necessary.  In addition to her medical malpractice litigation practice, Kristen has experience with federal and state healthcare regulatory compliance, as well as business transactions involving...

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