AHA Asks HHS For Leniency In Enforcing Transparency Rules

The American Hospital Association is urging the U.S. Department of Health and Human Services to exercise enforcement discretion regarding hospital price transparency rules.

“Hospitals’ ability to comply with the rule at this time is particularly challenged by an increase in the volume of COVID-19 patients and the need to distribute multiple vaccines,” Richard Pollack, AHA president and CEO, wrote in a January 7 letter to HHS Secretary Alex Azar. “Both of these events are straining hospital and health system resources at a critical time in the course of the pandemic sweeping the nation. These strains are further compounded by the considerable gaps in federal guidance creating compliance uncertainty and recent legislation placing new price transparency requirements on hospitals.

“In light of these exigencies, we urge you to exercise enforcement discretion until the end of the public health emergency.”

COVID-19 has strained hospital and health systems since last March, the letter said, and the recent increase in cases and the need to distribute vaccines have further increased the workload for health professionals. Pollack cited three examples:

  • * The same revenue and IT departments needed to implement this rule are critical when it comes to building out hospital surge capacity.
  • * The same IT staff who are responsible for updating hospital websites with machine-readable files and creating new, consumer-friendly websites with shoppable service information also are responsible for building a tracking system for COVID-19 vaccine administration to comply with state and federal reporting requirements.
  • * The same revenue and billing staff integral in coordinating the development of machine-readable files also are needed to establish a new system for the administration of COVID-19 vaccines and managing the cancellation and rescheduling of hundreds to thousands of procedures.

Pollack said hospitals also lack sufficient guidance from the agency.

“Among the most significant gaps is guidance for which rate hospitals should use when no rate exists in the contract,” the letter said. “Specifically, the Centers for Medicare & Medicaid Services requires hospitals to post a list of their standard charges — including the gross charges, negotiated rates, de-identified minimum and maximum negotiated rates, and discounted cash price — for all items and services in a machine-readable format on their websites. However, there are a number of instances where a single negotiated rate simply does not exist.”

Finally, Pollack wrote, the difficulties in implementation are further compounded by legislation passed at the end of the year that includes additional transparency requirements for providers. “A great deal of coordination will be required to mesh the current and new requirements, and the focus should remain on those that best assist patients in understanding what they will pay and thus enable them to be more prudent purchasers of health care,” the letter concluded. “We again ask that the agency exercise enforcement discretion at least until the end of the public health emergency and use that time to effectively mesh the new and existing requirements.”


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