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1 1 (January 13, 2020)

handle is hein.crs/govbixu0001 and id is 1 raw text is: Resarh Service CMS's Hospital Price Transparency Final Rule and Related Legal Challenge January 13, 2020 Addressing the rising cost of health care, including reducing the prices consumers pay for health care services and products, has been an area of interest for Congress and the Trump Administration. One approach is promoting price transparency, which proponents argue could lower costs by enabling healthcare consumers to comparison shop, prompting providers of healthcare services and products to offer more competitive pricing. The Administration has announced price transparency proposals both in the context of prescription drugs and health care provider services. Earlier in 2019, for instance, the Centers for Medicare and Medicaid Services (CMS) issued a final rule that would have required direct-to- consumer television advertisements for certain prescription drugs to disclose the drugs' list prices. Several pharmaceutical manufacturers sued to challenge the rule, and the U.S. District Court for the District of Columbia agreed, in a decision that the U.S. Department of Health and Human Services (HHS) has appealed to the D.C. Circuit, that this disclosure requirement exceeded the Secretary's statutory authority under the Social Security Act. More recently, CMS, on November 15, 2019, issued a final rule (effective January 1, 2021) that requires each hospital operating in the United States to post to the public online a yearly list of five types of standard charges for every item and service it provides, discussed below. Like the drug price disclosure rule, this hospital price transparency rule has sparked debate and drawn a legal challenge by entities- here, several hospitals and hospital associations-affected by the rule. Given the legal challenge, this sidebar provides an overview of the CMS hospital price transparency final rule, the bases of the legal challenge against it, and how the legal challenge may be relevant to other legislative healthcare price transparency proposals that Members of Congress may continue to consider. CMS Hospital Price Transparency Final Rule CMS issued the hospital price transparency final rule to implement Section 2718(e) of the Public Health Service Act (PHSA). Enacted as part of the Patient Protection and Affordable Care Act (ACA), Section 271 8(e) requires each hospital operating in the United States to establish, update, and make public annually, in accordance with guidelines developed by the Secretary, a list of the hospital's standard charges for items and services provided by the hospital, including for diagnosis-related groups established under section 1886(d)(4) of the Social Security Act. When CMS initially implemented this Congressional Research Service https://crsreports.congress.gov LSB10392 CRS LegA! SidebaF Prpred For Meumbers and Comrm ttees of Conress ----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------

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