Hospital Charge Disclosure
- Beginning January 1, 2019, the U.S. Department of Health & Human Services and Centers for Medicare and Medicaid Services (CMS) are requiring hospitals and health systems to post their “current, standard charges.”
- Hospital charges are the amount a hospital bills an insurer for a service. For most patients, hospitals are reimbursed at a level well below charges. Patients covered by commercial insurance products have negotiated rates with hospitals. Patients covered by Medicare or Medicaid programs have hospital reimbursement rates determined by federal and state governments.
- Hospital charges may include bundled procedures, personnel, services and supplies. An example would be room rates that include the space, equipment, nursing personnel and supplies.
- When a patient has the opportunity to shop for medical services, he or she should contact his or her own insurance carrier to understand which costs will be covered and which will be the patient’s responsibility.
- Patients should contact the hospital directly for any further details.