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Hospital Price Transparency Rule to Go Forward: D.C. Court Upholds Legality of Rule


On November 15, 2019, the Centers for Medicare & Medicaid Services (CMS) released its final rule on hospital price transparency. As anticipated, the American Hospital Association (AHA) filed a lawsuit against the Department of Health and Human Services (HHS) to block implementation of the rule. On June 23, 2020, a D.C. District Court judge upheld the legality of the price transparency rule, allowing the implementation of the rule to move forward January 1, 2021. Although AHA will likely appeal, hospitals should consider taking the necessary steps to comply with the price transparency rule. It should be noted that compliance is expected to be extremely onerous in light of the extensive amount of information required, thus hospitals should not wait until the last minute to prepare.

In granting HHS’ motion for summary judgement and denying that of AHA, Judge Nichols determined that CMS and HHS implemented the rule within their regulatory authority. Specifically, Judge Nichols found that CMS’ interpretation of “standard charges” in 42 U.S.C. § 300gg-18(e) was a permissible interpretation. The Court further determined that the rule does not violate hospitals’ first amendment rights and the rule will not present antitrust concerns. The Court’s 43 page opinion can be accessed here.

MMM’s November 20, 2019, legal update explaining the contents and requirements of the price transparency rule can be read here.

Please contact MMM’s healthcare group with any questions or for assistance.