Provider Charge Data Reporting: 50 State Comparison

A.R.S. § 36-125-.05: Hospitals must report average charge per day to the Department of Health.  Emergency departments must report charges for outpatient services to the Department.  All reports must be available for public inspection.

A.R.S. § 36-436: A new hospital or nursing facility must file a schedule of its rates and charges (and rules that relate to those rates and charges) with the Director of the Department of Health Services for review. 

Health & Safety Code § 1339.56:  Each hospital must compile a list of 25 common outpatient  and inpatient procedures and annually submit to the Office of Statewide Health Planning and Development the hospital’s average charges for those procedures. 

Health & Safety Code § 128735: Any organization that operates, conducts, owns, or maintains a health care facility, (or its officers) must report the total charges for each discharged patient to the Office of Statewide Health Planning and Development.

C.G.S.A.: § 19a-681: Each hospital must file with the Office of Health Care Access its current pricemaster, which must include each charge in its detailed schedule of charges.

F.S.A. § 408.061: The Agency for Health Care Administration must require health care facilities, providers, and health insurers to submit actual charge data by diagnostic group to the Agency.

20 ILCS 2215/4-2: Each licensed hospital and ambulatory surgery center must submit to the Department of Public Health inpatient and outpatient claims and encounter data for surgical and invasive procedures performed on each patient within 60 days of the end of each calendar quarter. 

K.R.S. § 216.2929: The Cabinet on Health and Family Services must make available on its website information on charges for health care services in easy to understand language that allows consumers to make comparisons between each hospital and ambulatory facility by payer and for other provider groups as data becomes available. Any charge information compiled by the Cabinet must include the median charge and other percentiles to describe the typical charges, and include the total number of patients represented by all charges.  The report must clearly identify data sources.

Maine Rev. Stat. § 8712: The Maine Health Data Organization must produce an annual report that compares the 15 most common diagnostic-related groups and the 15 most common outpatient procedures for all hospitals in the state and the 15 most common procedures for nonhospital health care facilities in the state to similar data available from other states.  The Organization must also provide an annual report of the 10 procedures most commonly provided by osteopathic and allopathic physicians in private office settings in the state.

M.G.L.A. 12C § 8: The Center for Health Information and Analysis must require the uniform reporting of revenues, charges, costs, prices, and utilization of health care services by institutional providers, their parent organizations, and affiliated entities.  The Center must require acute and non-acute hospitals to file the charge book, cost data, audited financial statements, and merged billing and discharge data with the Center.

M.G.L.A. 12C § 10: The Center requires hospital inpatient and outpatient cost data as well as relative prices paid to each hospital, registered provider organization, physician group, ambulatory surgery center, and other health care facilities, by provider type, with separately listed inpatient and outpatient prices by product, to be submitted from private health care payers.

M.S.A. § 62J.82: The Minnesota Hospital Association must develop a web-based system available to the public for reporting of charge information, including number of discharges, average length of stay, average charge, average charge per day, and median charge for the 50 most common inpatient diagnosis related groups and the 25 most common outpatient surgical procedures, as determined by the Minnesota Hospital Association.

M.S.A. § 62U.04: The Commissioner must publicly report the providers' total cost, total resource use, total quality, and the results of the total care portion of the peer grouping process, information on providers' condition-specific cost, condition-specific resource use, and condition-specific quality, and the results of the condition-specific portion of the peer grouping process, annually. 

V.A.M.S. § 192.667: Under the statute, health care providers must report charge data to the Department at least annually, while hospitals must report patient abstract data and financial data annually. 

N.H. Rev. Stat. § 126:25: Each nursing home, acute care hospital, residential care facility, specialty hospital, or other licensed health care facility must file with the Commissioner of the Department of Health and Human Services charge data.  For acute care or specialty hospitals with less than a 30 day average stay, charge by discharge, and for specialty hospitals and nursing homes, the average patient day charge must be filed.

N.C.G.S.A. § 131E-214.4:  A statewide data processor must make available annually a report that includes the 35 most frequently reported charges of hospital and freestanding ambulatory surgical centers to the Division of Health Service Regulation of the Department of Health and Human Services. 

Ohio Rev. Code § 3727.34: Each hospital must annually submit to the Director of Health, for patients in each of the sixty most commonly treated diagnosis-related groups for the previous calendar year, the mean, median, and range of total hospital charges.  Each hospital must annually submit to the Director of Health the mean and median of total hospital charges for the services relating to outpatient services for each of the sixty categories of outpatient services most frequently provided by the hospital as represented by outpatient discharges for the previous calendar year.

O.R.S. § 442.460: In order to obtain regional or statewide utilization information, the Office for Oregon Health Policy and Research may receive information on utilization and cost identified by the Administrator, from physicians, insurers, employers, or other third party purchasers of health care services.      

R.I. Gen. Laws § 23-17.17-10: Insurers, health care providers, insurers, and governmental agencies must file reports, data, and schedules, including information related to hospital finance and other information relating to health care costs, prices, utilization, quality, or resources required to be filed by the Director.

SDCL § 34-12E-11: All licensed hospitals must report to the South Dakota Association of Healthcare Organizations, the charge information for the hospital’s All Patient Refined Diagnosis-Related Groups for which that hospital had at least ten cases during the previous year. 

V.T.C.A. Health and Safety Code § 108.006: The Texas Health Care Information Council must develop a statewide health care data collection system to collect health care charges, utilization data, provider quality data and outcome data.

18 V.S.A. § 9405b: The Commissioner of the Department of Financial Regulation with other health care stakeholders must establish a standard format for hospital community reports, which must include valid, reliable, and useful measures for comparison of charges for higher volume health care services.

18 V.S.A. § 9410: The Commissioner of the Department of Financial Regulation must establish and maintain a unified health care database in order to compare costs between treatment settings and approaches and provide information to consumers and purchasers of health care.  The Commissioner may require a health plan covering 5% of covered lives to file a consumer health care price and quality information plan with the Commissioner.

W.S.A. § 146.903: The Department of Health Services must, for each type of provider, annually identify the 25 most common conditions for which the provider provides services.  Health care providers must submit a single document that lists the median billed charge, Medicare payment to the provider, and average allowable payment from third party payers for the 25 most common conditions the provider treats.  Each hospital must prepare a single document containing the median billed charge, Medicare payment to the provider, and average allowable payment from third party for 75 specific diagnosis-related groups for inpatient care and 75 specific outpatient surgical procedures.