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
Nov 04, 2021

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.

May 04, 2021

CMS Begins Enforcing Hospital Price Transparency Rule

CMS is auditing acute care hospitals for compliance with the hospital price transparency rule, which took effect January 1, 2021.

Dec 23, 2020

CMS Price Transparency Requirements Effective Jan. 1, 2021

CMS issued final price transparency requirements for hospitals, requiring all hospitals to make public their negotiated rates in specific file formats on their websites

Oct 29, 2020

Health Plan Price Transparency Rule Finalized

On Oct. 29, the U.S. Department of Health and Human Services, the U.S. Department of Labor and the U.S. Department of the Treasury released the Transparency in Coverage final rule. 

Nov 21, 2019

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.

Dec 05, 2022

HHS Delays Enforcement of GFE Co-Provider Requirements

Pending future rulemaking, HHS delayed requirements to include co-provider and/or co-facility expected charges for uninsured or self-pay good faith estimates.

Nov 15, 2022

IHA Comments on No Surprises Act AEOB and GFE Requirements

IHA comments on future advanced explanation of benefits and good faith estimate requirements for insured individuals.

Aug 31, 2022

No Surprises Act: Updated QPA and IDR Requirements

IHA summarized new final rules updating qualifying payment amount (QPA) and federal independent dispute resolution (IDR) requirements.

Jun 27, 2022

Public Act 102-0901 State Surprise Billing Legislation

Public Act 102-0901/HB 4703, effective July 1, 2022, amends Illinois’ surprise billing law to better align with the Federal No Surprises Act. Certain provisions of law go into effect Jan. 1, 2023.

May 16, 2022

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.

Apr 18, 2022

April 2022 No Surprises Act Update

The Centers for Medicare & Medicaid Services recently posted several updates on the CMS Federal Independent Dispute Resolution portal and recent No Surprises Act guidance.

Dec 21, 2021

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.

Dec 08, 2021

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.

Dec 06, 2021

IHA Comments on Surprise Billing Regulations, Part II

IHA urges delayed enforcement of surprise billing regulations, as well as revisions to the independent dispute resolution and good faith estimate processes.

Nov 10, 2021

Federal No Surprises Act Implementation

IHA shares concerns on the No Surprises Act, which outlined new patient protections from surprise medical bills and requirements for healthcare providers and health plans.

Oct 20, 2021

Detailed Summary: No Surprises Act, Implementing Regulations Part II

IHA summarizes the second regulation implementing the No Surprises Act, including details on required good faith estimates and dispute resolution processes.

Oct 12, 2021

IHA Comments on Surprise Billing Enforcement Proposed Rule

IHA again urges deferred enforcement of surprise billing regulations, as well as increased transparency on how payers calculate qualifying payment amounts.

Sep 03, 2021

IHA Comments on Surprise Billing Regulations

IHA urges delayed enforcement of surprise billing regulations, citing the need for additional guidance, clarification, and resources to realize the goals of the No Surprises Act.

Aug 12, 2021

IHA Comments on Surprise Billing Notice and Consent and Model Disclosure Documents

IHA urges HHS to use consistent language throughout these documents and to ensure these documents mirror the required content and guidelines described in the final rule.

Jul 26, 2021

IHA Summary of No Surprises Act, Implementing Regulations Part 1

IHA summarizes the first of several regulations implementing the No Surprises Act, including how this law interacts with the State’s surprise billing law.

Feb 02, 2021

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)

IHA Webinar: No Surprises Act: Hospital Requirements (11/15/21)

IHA Webinar: Ensuring Compliance with the Price Transparency Final Rule (9/15/20)

IHA Webinar: Price Transparency Final Rule Compliance: Three Vendor Options (11/4/20)

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

American Hospital Association Resources

AHA Good Faith Estimate Infographic

IRS Section 501(r) Regulation

An IRS final rule on December 31, 2014 adds requirements for hospitals to maintain exemption from federal income tax under Section 501(c)(3).

The Hospital Uninsured Patient Discount Act

The Hospital Uninsured Patient Discount Act requires hospitals to provide free and discounted care to eligible uninsured patients.

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.