(June 6, 2025) – On Thursday, the Centers for Medicare & Medicaid Services began implementing revised hospital price transparency requirements as part of a February executive order enhancing oversight of price transparency requirements enacted in 2021. In its new guidance, CMS requires hospitals to include a 'standard charge dollar amount' in their machine-readable files whenever possible. This should include gross charges, cash prices, payer-specific negotiated rates and any minimum negotiated charges – the lowest charge a hospital can negotiate for products and services across all payers. In instances where hospitals cannot list charges in actual amounts, CMS says charges should be listed as percentages, with additional details provided elsewhere in the data file explaining the factors used to calculate them.
As more information becomes available, KHA will inform our members.
--Shannan Flach