Understanding Arizona Hospital Chargemaster Regulations
Arizona hospitals are required to submit their Chargemaster schedules to the Arizona Department of Health Services for review and publication. The Chargemaster document forms the basis for health care bills, yet its contents and processes lack transparency and consistency. Public access to Chargemaster details is limited, and the information submitted does not directly correlate with hospital cost data provided elsewhere. Compliance with Arizona laws and guidelines is critical for hospitals and nursing care institutions operating in the state.
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Hospital Chargemaster there seems to be no process, or rationale, behind the core document that is the basis for hundreds of billions of dollars in health care bills. Steven Brill, Time Magazine Feb. 22, 2013 1 Reaching across Arizona to provide comprehensive quality health care for those in need Our first care is your health care Arizona Health Care Cost Containment System
Since 1972 Arizona hospitals have been required to submit their Chargemaster to ADHS at least quarterly 2 Reaching across Arizona to provide comprehensive quality health care for those in need Our first care is your health care Arizona Health Care Cost Containment System
A.R.S. 36-436 A. A new hospital or nursing care institution shall not engage in business within this state until there is filed a schedule of its rates and charges and rules that relate to those rates and charges with the director for the director's review. The schedules of rates and charges shall be in the form and contain information prescribed by the director. B. The director shall adopt or establish reasonable guidelines for review of rates and charges for hospital or nursing care institutions. Those health care institutions which are classified by the director as hospitals pursuant to section 36-405, subsection B shall use the current edition of the statement on the financial requirements of health care institutions and services, as adopted by the American hospital association, or amended editions thereof if applicable, as a guide for establishing hospital rates and charges. C. After a hospital or nursing care institution files the schedule required under subsection A of this section, the director shall promptly review the schedule within sixty days and publish information on gross charges based on that schedule. 3 Reaching across Arizona to provide comprehensive quality health care for those in need Our first care is your health care Arizona Health Care Cost Containment System
Public Access Chargemaster detail information is not available to the public except by special request. Posting is limited to information on the: Rates and Charges Overview Form 4 Reaching across Arizona to provide comprehensive quality health care for those in need Our first care is your health care Arizona Health Care Cost Containment System
Arizona Hospital Compare Chargemaster information submitted to ADHS has no relationship to hospital cost information provided by Arizona Hospital Compare The Chargemaster is not used to create hospitals AHRQ cost to charge ratio Chargemaster line items have no association with the financial information disclosed in the Medicare Cost Report, Audited Financial Statements, and Uniform Accounting Report. 5 Reaching across Arizona to provide comprehensive quality health care for those in need Our first care is your health care Arizona Health Care Cost Containment System
Examples of How Charge Masters/Hospital Prices are Reported in Other States 6 Reaching across Arizona to provide comprehensive quality health care for those in need Our first care is your health care Arizona Health Care Cost Containment System
California California has a public website with hospital charge data only for the most common procedures. Charge data on a wider array of procedures is available by request. No reporting format consistency. http://www.oshpd.ca.gov/chargemaster/ 7 Reaching across Arizona to provide comprehensive quality health care for those in need Our first care is your health care Arizona Health Care Cost Containment System
Illinois Illinois has hospital and provider charges online, but only for the most common inpatient and outpatient procedures. The state also makes the same information, for all procedures-- publicly available in a report. http://www.healthcarereportcard.illinois.gov/h ospitals/view/101276 8 Reaching across Arizona to provide comprehensive quality health care for those in need Our first care is your health care Arizona Health Care Cost Containment System
Virginia Virginia has charge data for hospitals and providers, for most inpatient and outpatient procedures, publicly available on a website. A public report contains charge data and paid amounts for providers and hospitals for all procedures. http://www.vhi.org/health_care_prices.asp 9 Reaching across Arizona to provide comprehensive quality health care for those in need Our first care is your health care Arizona Health Care Cost Containment System
Massachusetts Massachusetts has a searchable public website with charges and paid amounts for hospitals and providers for most common inpatient and outpatient procedures. A subset of information is also available upon request in a public report. Website also includes quality measures. http://hcqcc.hcf.state.ma.us/ 10 Reaching across Arizona to provide comprehensive quality health care for those in need Our first care is your health care Arizona Health Care Cost Containment System
