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Hospitals face major decisions on how to approach price transparency rule after legal defeat

June 25, 2020 / by Robert King

A court ruling upholding a controversial price transparency rule puts hospitals in a tight spot of how to comply with the regulation in the middle of a pandemic.

Hospital groups were dealt a major setback when a federal judge sided with the Centers for Medicare & Medicaid Services to uphold a rule that requires facilities to post payer-negotiated rates for 300 services. Even though the groups issued plans to appeal, hospitals must weigh whether to start preparing for the rule that goes into effect on Jan. 1, 2021.

“They need to be thinking about the practical implications of their compliance,” said Michael Abrams managing partner of the consulting firm Numerof Associates. “They will need to make public information about pricing that has not up until now been public.”

The goal of the CMS rule is to give consumers an option to price shop and hopefully lower costs, Abrams said.

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Mike Adams

Mike Adams is a medical device sales leader with extensive clinical experience in spine and biologics and a nationwide distribution network built over the last 10+ years in the industry. He has held various leadership positions in healthcare and device including Distributor Partner, Hospital COO and Spine VP of Sales. He currently leads the commercialization strategy for OrthoSpine Partners and is a Distributor Principal at Novel Medical. Because of his unique career path, Mike has the ability to see the healthcare business from multiple perspectives making him passionate about building strategic partnerships that help reduce overall costs, drive innovation, and cultivate growth for new markets.

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