In rules promulgated under the Affordable Care Act, starting January 1, 2019, hospitals are required to publish a list of their standard charges. In the industry, this is known as the "chargemaster". When you sign an admission form to be liable for the cost of your service, unless you have an insurance contract that specifies discounted charges, you are agreeing to pay the "chargemaster"price. Insurance companies generally do negotiate discounts, and governmental agencies generally pay 65% of the chargemaster rates.
This is still relevant to individuals because from time to time, there are still services not covered by insurance, either because of a policy exclusion or because the facility is out of network. Note also that this regulation only applies to hospitals. Facilities that aren't deemed to be hospitals and standard doctor offices aren't covered by this rule.
https://www.appliedpolicy.com/navigating-cms-rules/new-requirements-for-hospitals-pertaining-to-chargemasters-effective-january-1-2019/
In litigation over medical bills, hospitals have fought disclosure of their chargemasters even when they have sued the patient for the bill, claiming the chargemaster is a trade secret. This new rule should be helpful in at least getting hospitals to turn over the chargemasters in defensive litigation.
https://www.appliedpolicy.com/navigating-cms-rules/new-requirements-for-hospitals-pertaining-to-chargemasters-effective-january-1-2019/
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About The Consumer Law Office of Steve Hofer
Steve Hofer has been practicing consumer law in Indiana for more than 20 years. He is a former Indiana State Chairperson of the National Association of Consumer Advocates, a national organization of attorneys striving for fairness in the consumer marketplace. Contact me by phone at 317-662-4529 or via email at hoferlawindyATgmail.com. You can also leave a message through my website at www.hoferlawindy.com.
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