Rhode Island § 23-103-3 - Disclosure of Prices — Medical Facility Items

§ 23-103-3. List of standard charges required.

(a) A facility shall:

(1) Maintain a list of all standard charges for all facility items or services in accordance with this section; and

(2) Ensure the list required under subsection (a)(1) of this section is available at all times to the public, including by posting the list electronically in the manner provided by this section.

(b) The standard charges contained in the list required to be maintained by a facility under subsection (a) of this section shall reflect the standard charges applicable to that location of the facility, regardless of whether the facility operates in more than one location or operates under the same license as another facility.

(c) The list required under subsection (a) of this section shall include the following items, as applicable:

(1) A description of each facility item or service provided by the facility;

(2) The following charges for each individual facility item or service when provided in either an inpatient setting or an outpatient department setting, as applicable:

(i) The gross charge;

(ii) The de-identified minimum negotiated charge;

(iii) The de-identified maximum negotiated charge;

(iv) The discounted cash price; and

(v) The payor-specific negotiated charge, listed by the name of the third-party payor and plan associated with the charge and displayed in a manner that clearly associates the charge with each third-party payor and plan; and

(3) Any code used by the facility for purposes of accounting or billing for the facility item or service, including the Current Procedural Terminology (CPT) code, the Healthcare Common Procedure Coding System (HCPCS) code, the Diagnosis Related Group (DRG) code, the National Drug Code (NDC), or other common identifier.

(d) The information contained in the list required under subsection (a) of this section shall be published in a single digital file that is in a machine-readable format.

(e) The list required under subsection (a) of this section shall be displayed in a prominent location on the home page of the facility’s publicly accessible internet website or accessible by selecting a dedicated link that is prominently displayed on the home page of the facility’s publicly accessible internet website. If the facility operates multiple locations and maintains a single internet website, the list required under subsection (a) of this section shall be posted for each location the facility operates in a manner that clearly associates the list with the applicable location of the facility.

(f) The list required under subsection (a) of this section shall:

(1) Be available:

(i) Free of charge;

(ii) Without having to establish a user account or password;

(iii) Without having to submit personal identifying information; and

(iv) Without having to overcome any other impediment, including entering a code to access the list;

(2) Be accessible to a common commercial operator of an internet search engine to the extent necessary for the search engine to index the list and display the list as a result in response to a search query of a user of the search engine;

(3) Be formatted in a manner prescribed by the commission;

(4) Be digitally searchable; and

(5) Use the following naming convention specified by the Centers for Medicare and Medicaid Services, specifically:

(i) In prescribing the format of the list under subsection (f)(3) of this section, the commission shall:

(A) Develop a template that each facility shall use in formatting the list; and

(B) In developing the template under subsection (f)(5)(i)(A) of this section:

(I) Consider any applicable federal guidelines for formatting similar lists required by federal law or rule and ensure that the design of the template enables healthcare researchers to compare the charges contained in the lists maintained by each facility; and

(II) Design the template to be substantially similar to the template used by the Centers for Medicare and Medicaid Services for purposes similar to those of this chapter, if the commission determines that designing the template in that manner serves the purposes of subsection (a) of this section and that the commission benefits from developing and requiring that substantially similar design.

(g) The facility shall update the list required under subsection (a) of this section at least once each year. The facility shall clearly indicate the date on which the list was most recently updated, either on the list or in a manner that is clearly associated with the list.