Onerous Price Transparency Regulation Looms as COVID-19 Flares in Rural America

On January 1, 2021, the Centers for Medicare and Medicaid Services (CMS) is slated to implement a price transparency regulation that will require all hospitals, including critical access hospitals (CAHs), to develop a list of shoppable services in an effort to help patients better understand the cost of care for non-emergent services. This regulation must be delayed.

Practically all hospitals, and especially rural hospitals, have not had the time nor the resources they needed to comply with the price transparency requirements during the COVID-19 public health emergency (PHE). Half of all states are reporting increases in new COVID-19 cases, and several are setting new records for new daily cases reported, including rural states such as Montana and South Dakota.

Additionally, the regulation requires hospitals to disclose negotiated rates for their services. Unlike large urban systems, rural hospitals have absolutely no bargaining power when negotiating rates with managed care plans; they simply accept the rates offered. Rural hospitals could lose millions in revenue, and many already face negative operating margins and are on the verge of closure. Put simply, if CMS implements the price transparency regulation, hospitals will risk noncompliance and financial penalties, and many rural hospitals will close.