The Affordable Care Act requires hospitals to make public their
standard charges for items and services provided by the hospital . The CMS
final rule allows hospitals
to either make public a list of their charges (their charge master or another
form of their choice) or their policy for allowing the public to view a list of
those charges. The stated intent of the federal rule is to help patients
understand what their potential financial liability might be for services provided
and to compare charges for similar services across hospitals. For a patient to adequately
assess their financial liability for the medical services they receive from any hospital
they need to contact their insurance company and determine which services are covered and
non-covered, their deductible, and any other out pocket payments they may incur. The
hospital chargemaster does not indicate what a hospital receives in reimbursement;
that is determined by Payor contracts and the allowables set by the payors. If a
patient does not have insurance, they can contact the hospital directly.
