Dive Brief:

  • The American Hospital Association filed an emergency motion for a stay, which means it's seeking to stop the government from enforcing its price transparency rule, set to go into effect Jan. 1 if the law is not struck down in federal appeals court.
  • The AHA is still awaiting a final verdict from the court after the three-judge panel heard oral arguments in October. In the meantime, the group is hoping to bar the law from going into effect as hospitals are overwhelmed by the rollout of the coronavirus vaccines and record-high COVID-19 caseloads.
  • Emergency relief is warranted, AHA said, because CMS will start conducting audits of price transparency compliance and those not following the regulations face financial penalties, the parties said in a Monday filing.

Dive Insight:

A CMS bulletin from last Friday led AHA to file the emergency request with the federal appeals court. The notice informed providers that CMS is prepared to "audit a sample of hospitals for compliance starting in January" and those providers found in violation will face civil monetary penalties.

AHA argues that halting the policy is necessary given the "exceptional circumstances" the industry faces.

………

Meanwhile, the hospital lobby is still waiting on the ruling from federal appeals court. But after listening to oral arguments back in October, industry experts don't feel AHA will prevail in the case, which is seeking to knock down the law.

The three-judge panel seemed highly skeptical that it is unlawful for the government to compel providers to publish the negotiated rates they reach with insurers for services provided to patients.

The hospitals can literally turn over pricing data at the press of a button, but the hospitals want to continue to profit over secrecy, and they are hoping to put one over on the incoming administration.