The departments of Health and Human Services (HHS), Labor, and the Treasury on May 22 issued updated guidance and requests for information (RFIs) seeking to amend hospital and health plan requirements to publish prices for items and services. Since 2021, the Centers for Medicare & Medicaid Services (CMS) has required hospitals to publish a machine-readable file (MRF) listing all standard charges for all items and services and a consumer-friendly list of standard charges for 300 “shoppable services.” The updated hospital transparency guidance (PDF) requires hospitals to publish actual dollar amounts of estimated charges in the MRF instead of using a value of 999999999 as the estimated allowed amount where no dollar amount is available, citing the CMS’ findings that hospitals have been underreporting actual dollar amounts. The hospital transparency RFI seeks input on improving compliance with hospital price transparency requirements. Comments are due July 21.
Separately, the departments issued an RFI (PDF) and guidance pertaining to health plan transparency requirements (PDF) under the Transparency in Coverage (TiC) rules. The departments request comments on implementing the prescription drug machine MRF disclosure requirements under the TiC rules. This would require health plans to report net prices for covered prescription drugs in their MRFs. Comments on the TiC RFI are due 30 days from when the RFI is published in the Federal Register.