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Analysis

Timeline of Trump's Push for Healthcare Price Transparency

By HealthLeaders Media Staff  
   November 15, 2019

The government has been busy these past two years promoting healthcare price transparency.

Here's an overview of selected major events in the Trump administration's push for mandatory price transparency in healthcare, which culminated Friday with a final rule and a proposed rule pertaining to hospitals and insurers:

August 2, 2018: The Centers for Medicare & Medicaid Services issues final rule to require hospitals to publish their chargemasters online in a machine-readable format by 2019.

January 1, 2019: Hospitals required to publish their standard list prices online in a machine-readable format. The rule includes no penalty for noncompliance.

January 10, 2019: CMS Administrator Seema Verma commends three health systems by name for their efforts to promote price transparency voluntarily.

February 11, 2019: Health & Human Services proposes to require health plans to give patients immediate electronic access to their medical claims and health information, at no cost, by 2020.

February 20, 2019: Six major hospital groups, including the American Hospital Association, send an eight-point checklist to Congress to frame their perspective on any potential legislative action on surprise medical bills.

March 4, 2019: "Simply put, hidden pricing means healthcare providers don't have to compete on cost," Verma says in a speech before the Federation of American Hospitals. "Transparency creates competition, and competition keeps prices down, because patients can shop."

March 7, 2019: A report in The Wall Street Journal highlights the Trump administration's process of weighing whether and how to require providers to disclose the rates they negotiate with payers.

March 18, 2019: Seventeen organizations representing health insurers, including America's Health Insurance Plans (AHIP), send a letter to Congress to frame their perspective on any potential legislative action on surprise medical bills, countering the earlier letter from the hospital groups.

May 8, 2019: HHS finalizes rule to require pharmaceutical companies to disclose prescription drug prices in direct-to-consumer TV ads for certain drugs covered by Medicare and Medicaid.

June 24, 2019: President Donald Trump issues executive order to direct federal agencies to push for greater price transparency among providers and insurers. The order is light on details and directs HHS to fill in the gaps.

July 8, 2019: Federal judge blocks the HHS final rule that would have required pharmaceutical companies to disclose prices in direct-to-consumer TV ads for certain drugs.

July 29, 2019: CMS proposes to require hospitals to disclose payer-specific negotiated rates for common shoppable services, such as imaging, outpatient visits, and lab tests, plus provide "consumer-friendly" price transparency tools by 2020.

September 10, 2019: CMS Administrator Seema Verma says in a speech before the American Hospital Association that those issuing "doomsday warnings about price transparency" typically benefit from the status quo. And "keeping prices a secret just isn't fair," she says.

September 27, 2019: Deadline for comments on the CMS proposed rule to require hospital to disclose their payer-specific negotiated rates. The agency received more than 3,800 comments.

October 23, 2019: HealthLeaders publishes the story "Price Transparency Is Coming. How Will You Prepare?"

November 1, 2019: CMS issues final rule on the Outpatient Prospective Payment System (OPPS) for 2020, indicating a separate rule on price transparency would be forthcoming.

November 15, 2019: CMS issues separate final rule on hospital price transparency, with an effective date of January 1, 2021, which is a year later than had been proposed. CMS also issued a proposed rule on health insurer price transparency. President Donald Trump spoke from the White House about the rules Friday afternoon.

January 1, 2021: Effective date for final rule that requires hospitals disclose their payer-specific negotiated rates.

Related: CMS Issues Final Rule on Hospital Price Transparency, Pushes Effective Date to 2021

Related: Hospitals Vow to Sue Trump Administration Over Price Transparency Final Rule

Related: Enforcing Hospital Price Transparency: Is $300 Max Daily Fine Big Enough?

Editor's note: A version of this timeline appears in the September/October edition of HealthLeaders magazine.


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