The Centers for Medicare and Medicaid Services (CMS) is providing additional information on new requirements to comply with the Hospital Price Transparency regulations, which require each hospital operating in the U.S. to publish a comprehensive machine-readable file (MRF) with the standard charges for all items and services the hospital provides. The initial Price Transparency requirements went into effect and monitoring and enforcement began on January 1, 2021.
The most recent changes to the Price Transparency Requirements took effect on July 1, 2024, requiring hospitals to use a CMS template layout and data specifications for making public the standard charge information in a comprehensive MRF. The expanded set of data elements required includes each type of standard charge (including payer-specific negotiated charges by payer and plan), item/service descriptions and relevant billing codes. You can these templates and additional guidance, including quick reference compliance checklists and Frequently Asked Questions, available here.
CMS will also host a webinar on October 21, 2024 to provide additional information to assist Hospitals in meeting new Hospital Price Transparency Requirements to take effect January 1, 2025. Additional new data elements required will include estimated allowed amounts, drug units of measurement, drug types of measurement, and modifiers.
CMS has also developed and published tools to support hospitals in meeting the requirements, including:
- Validator tools available in web browser and download forms which test MRFs against the required CMS template layouts and data specifications;
- MRF naming wizard tool, which assists users in generating compliant file names in accordance with the required naming conventions; and
- A TXT file generator to assist users in confirming their files contain the required attributes of information and to improve accessibility.
Hospitals should ensure their websites are updated with the most current requirements now and should make preparations to comply with the January 1 requirements this fall.
Ensure your hospital is prepared for the upcoming CMS Hospital Price Transparency requirements. Consult with our healthcare regulatory attorneys Lynda M. Johnson, Timothy C. Ezell, and Amie Schoeppel Wilcox today.