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Analysis

AHA Asks CMS to Delay Implementation of Price Transparency Rule

By Revenue Cycle Advisor  
   July 08, 2020

The pandemic shows no signs of abating, and hospitals can't afford to redirect scarce resources to comply with the requirements of the final rule, the AHA wrote.

A version of this article was first published July 8, 2020, by HCPro's Revenue Cycle Advisor, a sibling publication to HealthLeaders.

The American Hospital Association (AHA) is urging CMS to delay the effective date of the Hospital Outpatient Prospective Payment System (OPPS) Policy Changes: Hospital Price Transparency Requirements final rule.

It is currently set to go into effect January 1, 2021, and would require hospitals to post privately negotiated commercial payer charges among other requirements.

Hospitals are under extraordinary pressure due to the novel coronavirus (COVID-19) public health emergency (PHE), according to the AHA’s letter. Many hospitals have devoted the majority of their resources to managing surges of COVID-19 patients, adapting to rapidly changing emergency regulations, and making swift changes to the way care is delivered.

At the same time, hospitals have experienced unprecedented revenue shortfalls due to the cancellation of nonemergent procedures and patients postponing treatment. The pandemic shows no signs of abating, and hospitals can’t afford to redirect scarce resources to comply with the requirements of the final rule, the AHA wrote.

The final rule was published in November 2019 and in December 2019 the AHA filed a lawsuit arguing that the final rule is unlawful because it exceeds CMS’ statutory authority. On June 23, a federal judge rejected that claim and said that the final rule is legal under sections 2718(e) and section 2718(b)(3) of the Public Health Service Act and section 1102(a) of the Social Security Act.

The judge also dismissed the lawsuit’s claims that the final rule violates the First Amendment and will create confusion among consumers. The AHA is appealing that decision. In the letter, the AHA urges CMS to delay implementation until the issue is settled by the courts.

In addition, CMS has acknowledged the necessity of relaxing implementation dates of new rules in consideration of the COVID-19 PHE, the AHA wrote. In April, CMS announced it would temporarily relax enforcement of the Interoperability and Patient Access final rule. CMS could adopt a similar policy in this instance, according to the AHA’s letter.

Revenue Cycle Advisor combines all of HCPro's Medicare regulatory and reimbursement resources into one handy and easy-to-access portal. News is not just repeated from other sources. It is analyzed by our Medicare experts so professionals can comprehend any new rule and regulatory updates thoroughly. Learn more.


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