Issue link: https://beckershealthcare.uberflip.com/i/1424600
14 CFO / FINANCE CMS pitches billing, financial disclosure rules: 7 things to know By Ayla Ellison T he Biden administration issued pro- posed rules Sept. 10 that include a detailed process for enforcing surprise billing protections and disclosure require- ments for health plans and providers of air ambulance services. Seven things to know about the proposed rules: Insurer financial disclosures 1. HHS proposed requiring that health in- surers disclose how brokers and agents who assist with enrollment in individual health insurance coverage and short-term insurance are compensated. 2. e proposed rules would require issuers of individual health insurance and short-term, limited-duration plans to tell consumers how brokers and agents are directly and indirectly compensated for assisting with health insur- ance enrollment. 3. e proposed rules would require issuers to report to HHS the total amount of compen- sation paid by the issuer to individual agents and brokers for the preceding year. Surprise billing protections 4. e proposed rules include a process that CMS would use to determine if states are en- forcing new surprise billing protections for consumers. 5. If states fail to enforce the surprise billing protections, the proposed rules would allow CMS to take action against providers and fa- cilities by imposing civil monetary penalties of up to $10,000 per violation. Air ambulance reporting require- ments 6. HHS proposed that air ambulance provid- ers and health plans submit data for each air ambulance claim and transport for two years covered by the reporting requirements of the No Surprises Act. 7. e data collected will help HHS and the Department of Transportation develop a comprehensive public report on air ambu- lance services. n HCA to buy 5 Utah hospitals from Steward By Alia Paavola N ashville, Tenn.-based HCA Healthcare plans to acquire five Utah hos- pitals from Dallas-based Steward Health Care. The hospitals involved in the deal are Davis Hospital in Layton, Jordan Valley Medical Center in West Jordan, Jordan Valley Medical Center-West Valley Campus, Mountain Point Medical Center in Lehi and Salt Lake Regional Medical Center in Salt Lake City. Pending approval, the five hospitals will become part of HCA Healthcare's Mountain Division, which has 11 hospitals throughout Utah, Idaho and Alas- ka. "Utah is one of the fastest-growing areas in the country, and the state's need for healthcare continues to increase," said Sam Hazen, CEO of HCA Health- care. "We believe the addition of these facilities will help us improve health- care network options for patients and enable investment in services to meet increasing demand for healthcare. We look forward to welcoming them to the HCA Healthcare family." Steward Health Care said the sale will allow it to continue to grow and rein- vest in other states and locations served by the health system. "We are very proud of Steward's significant contributions to the quality and efficiency of operations in these facilities," said Steward Health Care Chair and CEO Ralph de la Torre, MD. n Raise the price transparency noncompliance fee from $300 to $5.5K a day, researchers say By Katie Adams F ederal price transparency rules are doing an insufficient job at maxi- mizing savings related to healthcare costs, according to research re- leased Sept. 14 by Georgetown University in Washington, D.C. Many hospitals are not yet compliant with CMS' price transparency rule, which took effect Jan. 1. It requires hospitals to post a machine-readable file with the negotiated rates for all items and services and display the prices of 300 shoppable services in a consumer-friendly format. The rule aims to save Americans money by allowing them to price shop for healthcare services. In many cases, hospitals that have posted the data hide it from web search engines or provide it in a format that makes analysis difficult, according to the report. The researchers provided the following three suggestions to improve price transparency compliance: 1. Increase the maximum noncompliance fee from $300 per day to $5,500 per day. 2. Require hospitals to present data uniformly through a machine-readable template that complies with CMS' regulations. 3. Ask hospitals to display their commercial and Medicare rates side by side. n