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ARIZONA STATE SENATE
Fifty-Sixth Legislature, First Regular Session
hospital; price transparency
Purpose
Requires all licensed hospitals to comply with federal hospital price transparency regulations and requires the Department of Health Services (DHS) to confirm each hospital's compliance.
Background
Federal hospital price transparency regulations require each hospital operating in the United States to annually establish, update and make public a list of the hospital's standard charges for provided items and services, including diagnosis-related groups (DRGs). The Centers for Medicare and Medicaid Services (CMS) evaluates whether a hospital has complied with the requirements and may proceed with the following if noncompliant: 1) provide a written warning notice of the specific violation to the hospital; 2) request a corrective action plan from the hospital; and 3) impose and publicize a civil monetary penalty on the hospital if the hospital has failed to respond or comply to CMS' request for a corrective action plan (45 C.F.R. § 180).
Health care facilities, excluding the Arizona State Hospital (ASH) and Indian Health Service (IHS) hospitals and facilities, are required to make available on request or online the direct pay price for, at least, the 50 most used DRG and outpatient service codes if the facility has more than 50 inpatient beds. Whereas, If the facility has 50 or fewer beds, the facility must make available the direct pay price for, at least, the 35 most used DRG and outpatient service codes. (A.R.S. § 36-437).
There is no anticipated fiscal impact to the state General Fund associated with this legislation.
Provisions
1. Requires licensed hospitals, including IHS hospitals and ASH, to comply with federal hospital price transparency regulations.
2. Requires DHS to annually confirm each hospital's compliance with federal hospital price transparency regulations.
3. Makes technical and conforming changes.
4. Becomes effective on the general effective date.
Prepared by Senate Research
February 3, 2023
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