The Price Transparency Act: Key Changes and Compliance for 2024
Understanding Latest CMS Guidance and Revisions To Ensure Continued Compliance and Avoiding Monetary Penalties
Watch Video
-
April 11, 2024
Downloads
Download Presentation
-
Overview of the Price Transparency Act
Q2 2024 Healthcare Quarter in Review Read Now
The Hospital Price Transparency rule enforces the mandate of Section 2718[e] of the Public Health Service Act by obligating every hospital in the United States to compile, regularly refresh, and disclose an annual list of standard rates for the goods and services they offer. This includes prices for diagnosis-related groups as defined in section 1886[d][4] of the Social Security Act. The Act specifies the requirement of the hospital that must be posted publicly on the hospital’s website.
New Requirements for 2024
Additional requirements have been outlined by CMS for 2024 that will require modifications to existing website and machine readable files to maintain compliance moving forward.
By January 1, 2024
Access to Hospital MRFs Improved
- Hospitals are required to include a TXT file in the root folder with MRF clarification and contact information.
- A ‘footer’ link on the hospital’s homepage must be placed, directing to the machine-readable file
By July 1, 2024
Standardization of Data Elements and Format
- Hospital MRFs must follow the CMS template layout and data specifications
- Expanded data elements to include, as applicable; hospital and MRF information, standard charge types, payer-specific negotiated charges, items/service description, billing codes
- Hospitals must affirm the inclusiveness, accuracy, and completeness of the standard charge information in the MRF
By January 1, 2025
Inclusion of Additional Data Elements
- New required data elements such as ‘Estimated Allowed Amount’, ‘Drug Unit of Measurement’, ‘Drug Type of Measurement’, and ‘Modifiers’ must be encoded in the MRFs.
Related Insights
Published
April 11, 2024
Key Contacts