New regulations and requirements from the CY 2024 OPPS and ASC Final Rule.
Further define each charge and separately list additional metadata about the file and hospital.
Hospital providers who proactively included this data in their MRFs should still parse out fields like plan names and drug units/measurements across their datasets.
MRFs must include the hospital name/info, versioning, financial aid policy, and hospital licensure number.
MRFs must disclose code types, separate plan names, and contracting methods. Drug and modifier details will be required as of 1/1/2025.
Hospital websites must include a .txt file in the root folder with a direct link to the MRF and a link in the website footer directing users to the MRF landing page.
Data validation rules for new and existing fields will allow for true standardization of price transparency data.
This change will drastically improve the industry’s ability to serve accurate information to consumers, but every provider will be impacted.
Consumer-friendly dollar amount is now required from formulaic rates.
No more questions about IP vs. Inpatient or MSDRG vs. MS-DRG: CMS is mandating specific values for several fields.
CMS takes the guesswork out by requiring hospitals to clearly state the date the MRF data was most recently updated.
CMS requires hospitals to post MRFs in one of three format and layout options. Hospitals can select the least burdensome option based on their MRF development process.
Simpler maintenance and efficient data storage thanks to multiple rows for a given charge and one set of columns for payer/plan name.
Easier analysis without technical tools thanks to one row for each charge and additional columns for each Payer/Plan name.
Most explicit since it allows for the storage of hierarchical and relational data in a plain text format.