Understanding Virginia's New Hospital Price Transparency Requirements

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In an effort to promote transparency and empower patients to make informed decisions about their healthcare, Virginia has introduced new requirements for hospitals regarding price disclosure. As of July 2023, hospitals in Virginia will be obligated to provide detailed information about their standard charges and offer advance estimates of patient payment amounts for elective procedures, tests, or services.

Standard Charges for All Items and Services

To improve price transparency, every hospital in Virginia must publish a machine-readable file on its website containing a comprehensive list of all standard charges for items and services provided by the hospital.

By making standard charges readily available to the public, patients can gain a clearer understanding of the potential costs associated with specific medical procedures or services before seeking treatment.

Advance Estimates of Payment Amounts for Elective Procedures

Hospitals are now required to furnish patients with an estimate of the payment amount they will be responsible for when scheduling elective procedures, tests, or services. Patients or their legally authorized representatives must make the request at least three days in advance of the scheduled date for the procedure.

Offering advance estimates of payment amounts allows patients to anticipate and plan for their financial responsibility, enabling them to make more informed decisions about their healthcare and avoid unexpected financial burdens.

Providing Written Information to Patients

Hospitals must display written information in public areas, including admissions or registration areas, and on their websites, informing patients about their right to request estimates of payment amounts under this new requirement.

By prominently displaying this information, hospitals ensure that patients are aware of their rights and can easily access the resources necessary to obtain the estimated payment amounts.

Transparency and Fairness for Patients

Virginia's new hospital price transparency requirements aim to empower patients with the knowledge they need to make informed decisions about their healthcare. By providing a detailed list of standard charges and offering advance estimates of payment amounts for elective procedures, tests, or services, hospitals in Virginia are taking important steps towards enhancing transparency in the healthcare industry. Patients can now have a clearer understanding of the costs involved in their medical treatments, allowing them to plan ahead and make well-informed choices for their health and financial well-being.

The new law came into effect on July 1, 2023. However, the Virginia Department of Health will not begin inspecting hospitals to ensure compliance until January 2024 at the earliest. If you believe you have not been reasonably informed of how to find pricelists by a hospital, or the hospital failed to provide you with pricing information within three days of requesting it, you should seek legal guidance on what recourse you may have. Contact us at Carroll & Nuttall, PC, today to find the best course of action for your specific circumstances.