Surprise Billing and Price Transparency: A New Era



Date & Time

Start Date: 05/17/2022
Start Time: 10:30 am
End Time: 11:30 am EDT


Shifting the $1 trillion dollar hospital industry from confidential payer contracts to publicly published pricing is a massive transformation. New CMS hospital price transparency requirements implicate public relations and business strategy issues, yielding a wide range of hospital and health system approaches to reporting the required data. As compliance increases, we are entering a world of publicly visible payer contracts which affect everything from negotiation strategies to value-based care. This session will discuss the specific regulatory requirements to report hospital pricing data, the risk of partial compliance, CMS penalties, and the implication of pricing transparency on confidentiality clauses in payer contracts. This session will also review a sample of Philadelphia-area pricing data and what this change means for payer negotiations, value-based care, pricing strategy, and other business issues. Christopher Raphaely will be joined by Cheryl Straup, Vice President, Compliance, Audit & Privacy at Advocare.


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R. Christopher Raphaely

Co-Chair, Health Care & Life Sciences

(215) 665-2099

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