Articles and Blogs

Price Transparency

Hall Render’s This Week in Washington – December 9, 2019

[12/09/19]

Posted on December 9, 2019 in Federal Advocacy

Published by: Hall Render

House and Senate Panels Announce Surprise Billing Fix On December 8, leaders from the Senate Health, Education, Labor, and Pensions (“HELP”) and House Energy and Commerce committees announced an agreement on surprise billing legislation. The proposal is intended to end surprise billing of patients by creating a new system of dispute resolution that includes... READ MORE

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The Price May Not Be Right, But It Will Be Public: CMS Finalizes Price Transparency Rule Requiring Hospitals to Publish Payer-Specific Rates

[11/18/19]

Posted on November 18, 2019 in Health Law News

Published by: Hall Render

On November 15, 2019, the Centers for Medicare & Medicaid Services (“CMS”) released the final rule on Price Transparency Requirements for Hospitals to Make Standard Charges Public (“Final Rule”) (available here). Despite broad opposition from the industry, CMS finalized the rule largely as proposed. CMS did delay the effective date until January 1, 2021,... READ MORE

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Hall Render’s This Week in Washington – November 15, 2019

[11/15/19]

Posted on November 15, 2019 in Federal Advocacy

Published by: Hall Render

CMS Releases Price Transparency Rules On November 15, CMS issued a proposed and final rule, both intended to increase the transparency in pricing for health care providers. One of the rules is the Calendar Year (“CY “) 2020 Outpatient Prospective Payment System (“OPPS”) final rule. The second rule is the Transparency in Coverage proposed... READ MORE

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Key Takeaways from 2020 Hospital Outpatient Prospective Payment System Final Rule

[11/08/19]

Posted on November 8, 2019 in Health Law News

Published by: Hall Render

On November 1, 2019, the Centers for Medicare & Medicaid Services (“CMS”) released its final rule for the Calendar Year (“CY”) 2020 Hospital Outpatient Prospective Payment System (“Final Rule”). Among many other changes, CMS finalized three key payment policy updates impacting hospital outpatient departments, including: (1) reducing payments for clinic visits at off-campus provider-based departments (“PBDs”);... READ MORE

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Here’s Price Transparency![1]

[09/13/19]

Posted on September 13, 2019 in Health Law News

Published by: Hall Render

On June 24, 2019, the Trump administration changed the game for the health care industry through the release of an executive order on price transparency. Entitled “Improving Price and Quality Transparency in American Healthcare to Put Patients First,” the executive order is aimed primarily at giving patients access to price and quality information about... READ MORE

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Discount Disruption: PBM Rebate Protection May Be Removed, New Safe Harbors Combat Increasing Drug Costs

[02/01/19]

Posted on February 1, 2019 in Health Law News

Published by: Hall Render

On January 31, 2019, the Department of Health and Human Services Office of Inspector General (“OIG”) issued a proposed rule that, if finalized, would eliminate Anti-Kickback Statute (“AKS”) safe harbor protection for prescription drug rebates paid by manufacturers to pharmacy benefit managers (“PBMs”), Medicare Part D plans and Medicaid managed care organizations (“Proposed Rule”).... READ MORE

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