Price Transparency
Patients need relevant information to understand the price of care and their financial responsibilities. IHA is committed to supporting hospitals in meeting price transparency requirements.
- Updates
- No Surprises Act
- Resources
- Laws
MLN Presentation on Hospital Price Transparency: Encoding Requirements in the Machine-Readable File
The Medicare Learning Network (MLN) hosted a December 9 webinar on encoding the January 1, 2025 requirements in the Machine-Readable File, as well as tips for implementation.
Updates to Hospital Price Transparency Requirements
An IHA memo outlines several modifications to the hospital price transparency rule that the Centers for Medicare & Medicaid Services finalized in the CY 2022 OPPS final rule.
IHA Summary: CMS Final Hospital Price Transparency Requirements
On Nov. 15, the Centers for Medicare & Medicaid Services issued final price transparency requirements for hospitals, including making public their negotiated rates.
No Surprises Act: Overview of Enforcement Responsibilities
A summary of State and Federal enforcement responsibilities regarding Illinois provider, facility and payer requirements under the No Surprises Act.
Surprise Billing Patient Notices and Disclosures Effective Jan. 1, 2022
This chart summarizes notices and disclosures providers must make available to patients under the No Surprises Act beginning Jan. 1, 2022.
Surprise Billing Policies Effective Jan. 1, 2022
An IHA summary outlines provisions of the No Surprises Act that go into effect on Jan. 1, 2022, including patient balance billing protections and public disclosure of patient rights.
Federal “No Surprises Act” Addresses Surprise Billing – IHA Summary
The No Surprises Act, found on page 1629, outlines new patient protections from surprise medical bills and new requirements for healthcare providers and plans. See IHA's summary.
IHA Webinar: Hospital Price Transparency Requirements (11/15/22)
- Slides (password required)
- Frequently Asked Questions (password required)
IHA Webinar: No Surprises Act: Hospital Requirements (11/15/21)
IHA Webinar: Ensuring Compliance with the Price Transparency Final Rule (9/15/20)
Talking Points on Health Plan Transparency in Coverage Rule – July 2022
Talking Points on Final Price Transparency Rule – January 1, 2021
IHA Infographic (12/22/20)
Average Charges for Illinois Hospitals
- The Illinois Department of Public Health collects inpatient and outpatient charge information from hospitals. Hospital-specific average charges for more than 50 major diagnoses are available on the Hospital Report Card and Consumer Guide to Health Care website.
Healthcare Financial Management Association Resources
- Understanding Healthcare Prices: A Consumer Guide
- Avoiding Surprises in Your Medical Bills: A Guide for Consumers
American Hospital Association Resources
AHA Good Faith Estimate Infographic
- See an infographic created by the American Hospital Association (AHA), which assists providers with good faith estimate (GFE) requirements under the No Surprises Act. When must a provider give a good faith estimate for a scheduled service?
Fair Patient Billing Act
Per The Fair Patient Billing Act, hospitals must notify patients about the availability of financial assistance and comply with specific requirements regarding billing and collections.