On November 15, 2019, CMS finalized its controversial rule regarding the public disclosure of payment rates that hospitals have negotiated with commercial payers. Effective January 1, 2021, CMS will require hospitals to make public not only their standard charges for their items and services, but also the rates that they have negotiated for their items and services with particular payers, the minimum and maximum amounts they charge for a particular item and service under any of their negotiated contracts, and the discounted amount they would accept for the item and service from a self-paying patient. Hospitals will be required to makes these disclosures in a consumer-friendly display for certain services that are designated as “shoppable” services. Hospitals that do not comply with these requirements will be subject to financial penalties. These rules present significant legal, financial, operational, IT and public relations risks.
King & Spalding will host a one-hour roundtable webinar on January 22, 2020 to discuss these requirements and their implications. Topics for discussion will include:
- How CMS defines the items and services and the various rates for such services that must be disclosed;
- The extent to which hospitals must disclose negotiated rates for employed or affiliated physicians;
- The implications of the rule for hospitals that are paid under capitated rates or other innovative payment models; and
- Potential areas of tension between the price transparency rules and hospitals’ other legal obligations, such as antitrust compliance.
Wednesday, January 22, 2020
1:30 P.M. – 2:30 P.M. ET
King & Spalding is an accredited provider of CLE credit in California, Georgia, Illinois, New York and Texas. We can issue reciprocal credit for attorneys licensed in Connecticut, Florida, and New Jersey. We will apply for credit in Colorado, North Carolina and Virginia (subject to MCLE Board approval). For jurisdictions not listed, attendees are provided with a Universal Certificate of Attendance. New York licensed attorneys: Transitional/Appropriate for newly-admitted and experienced attorneys. Financial aid is available for qualifying lawyers. For CLE-related questions, please contact Gisel Arias, firstname.lastname@example.org. King & Spalding, 1180 Peachtree Street NE, Atlanta, GA 30309. CA Provider #10947.