New Rule Requires Hospitals to Disclose Their Prices

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Hospital patient
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A hospital stay — for you or a loved one — is often a stressful time. The last thing you need is confusion about how much your care will cost.

A new federal regulation that went into effect on Jan. 1 aims to bring clarity to the pricing process.

The regulation, or rule, requires all hospitals operating in the U.S. to provide patients with “clear, accessible pricing information online about the items and services they provide,” according to the U.S. Centers for Medicare & Medicaid Services.

Specifically, CMS says the hospitals must provide their standard charges in a single digital file that is available online. These charges include:

  • Hospitals’ gross charges
  • The rates hospitals negotiate with insurance companies
  • The discounted prices hospitals will accept directly from patients who pay in cash

The goal is help consumers shop around for services that can be planned in advance by obtaining prices from multiple hospitals, according to CMS.

The federal agency says it expects to start checking whether hospitals are complying with the new regulation this month:

“CMS plans to audit a sample of hospitals for compliance starting in January, in addition to investigating complaints that are submitted to CMS and reviewing analyses of non-compliance, and hospitals may face civil monetary penalties for noncompliance.”

While the hospital price transparency rule is a step forward for patients, some experts say another recently finalized regulation that may be more helpful to consumers will not go into effect this year.

This other rule will require that insurance companies publish both the rates they negotiate with health care providers and a patient’s estimated out-of-pocket costs for many services, which are sometimes also referred to as a patient’s cost-sharing. But these requirements don’t start taking effect until 2022, and some take effect as late as 2024.

Nisha Kurani, a senior policy analyst at the Kaiser Family Foundation, tells CNBC:

“Seeing the payer-negotiated rates can be useful, but generally what’s more useful is the patient’s cost-sharing.”

How to lower your health care costs

Knowing how much a hospital charges can help you become a better shopper for health care services. Looking for more ways to cut costs? Check out “How Can I Lower My Health Care Costs?

Another great way to lower your expenses is to open a health savings account. If you are eligible for an HSA, you have access to one of the best tax breaks around. Learn more about HSAs in “3 Ways a Health Savings Account Can Improve Your Finances.”

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