Patients need relevant and meaningful information to understand the cost of care and their financial responsibilities. Hospitals across Illinois have committed to IHA’s price transparency principles.
IHA developed these principles with input from our CFO Forum to help focus and shape discussion as the healthcare industry moves toward greater transparency. 191 IHA member hospitals, or 92 percent, have pledged to adopt these principles.
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.
A summary of State and Federal enforcement responsibilities regarding Illinois provider, facility and payer requirements under the No Surprises Act.
The Centers for Medicare & Medicaid Services recently posted several updates on the CMS Federal Independent Dispute Resolution portal and recent No Surprises Act guidance.
See an infographic created by the American Hospital Association (AHA) assists providers with good faith estimate (GFE) requirements under the No Surprises Act.
This chart summarizes notices and disclosures providers must make available to patients under the No Surprises Act beginning 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.
IHA urges delayed enforcement of surprise billing regulations, as well as revisions to the independent dispute resolution and good faith estimate processes.
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.
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 summarizes the second regulation implementing the No Surprises Act, including details on required good faith estimates and dispute resolution processes.
IHA again urges deferred enforcement of surprise billing regulations, as well as increased transparency on how payers calculate qualifying payment amounts.
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.
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.
IHA summarizes the first of several regulations implementing the No Surprises Act, including how this law interacts with the State’s surprise billing law.
CMS is auditing acute care hospitals for compliance with the hospital price transparency rule, which took effect January 1, 2021.
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.
CMS issued final price transparency requirements for hospitals, requiring all hospitals to make public their negotiated rates in specific file formats on their websites
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.
IHA strongly supports providing patients with meaningful health coverage information, but has significant concerns with the proposed requirement for issuers to publicly disclosed negotiated rates.
On Nov. 15, the Centers for Medicare & Medicaid Services issued final price transparency requirements for hospitals, including making public their negotiated rates.
IHA appreciates the opportunity to comment on the proposed rule that would establish new price transparency requirements.
IHA's member memo summarizes the proposed price transparency requirements contained in the Medicare outpatient proposed rule.
The 21st Century Cures Act raises questions about price transparency. IHA comments on the proposed rule and describes the price transparency principles that Illinois hospitals have already adopted.
The Hospital Uninsured Patient Discount Act requires hospitals to provide free and discounted care to eligible uninsured patients.
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.
Nonprofit hospitals cannot charge patients eligible for financial assistance more than the amounts generally billed to patients with health insurance. Learn about the specific requirements.
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)
Insurance Plan Estimators
Average Charges for Illinois Hospitals
Checklist for Price Inquiries
Healthcare Financial Management Association Resources
Hospital Handout: Patient FAQs
Hospital Handout: Patient Request to View Standard Charges
American Hospital Association Resources