What are hospital pricemasters?
Pricemasters, also known as chargemasters, are the detailed schedules of all hospital charges. These documents are used by the Office of Health Strategy (OHS) to review patient bills filed in the OHS Consumer Assistance Process.
The pricemaster is required to be on file with the office in accordance with section 19a-681 of the Connecticut General Statutes. See Section 19a-643-203(a) (PDF) on page 63 of the Regulations of Connecticut State Agencies
When are hospitals required to file their pricemaster?
All hospitals must report the pricemaster they had in effect on October 1st to the Office of Health Strategy by November 15th.
New or revised charges that have not been previously reported to the Office of Health Strategy (OHS) must be submitted by the 15th of the following month. For example, the new or revised charges added during the month of November must be filed with OHS no later than December 15th.
What is required for the pricemaster filing?
Pricemaster filings must include three columns:
1. Item Code: The item codes used on the hospital’s detailed patient bills.
2. Item Description: The unique description of each item in the pricemaster that appears on the hospital’s detailed patient bills.
3. Item Price: The item price in effect on the last day of the month of the pricemaster submitted.
See Section 19a-643-204(b) (PDF) on pages 9-10 of the Regulations of Connecticut State Agencies
In what format must pricemasters be filed?
Pricemasters are uploaded to the OHS Notifications and Filings portal as MS Excel spreadsheets or PDF files.
How do I access pricemaster filings?
To view pricemasters, visit Notifications and Filings - Other Required Filings. Select a filing year, click on the Pricemasters tab, and click on the “funnels” to filter the results.
If you can’t find a document, please submit a Freedom of Information records request.
What statute authorizes OHS to collect acute hospitals’ pricemaster data?
View Connecticut General Statute §368z 19a-681.
What is the penalty for not providing a requested pricemaster?
Per C.G.S. § 19a-681(c) as amended by Public Act 13-234:
”…(c) Upon the request of the Office of Health Strategy or a patient, a hospital shall provide to the department or the patient a detailed patient bill. If the billing detail by line item on a detailed patient bill does not agree with the detailed schedule of charges on file with the office for the date of service specified on the bill, the hospital shall be subject to a civil penalty of five hundred dollars per occurrence payable to the state not later than fourteen days after the date of notification. The penalty shall be imposed in accordance with section 19a-653, as amended by this act. The office may issue an order requiring such hospital, not later than fourteen days after the date of notification of an overcharge to a patient, to adjust the bill to be consistent with the detailed schedule of charges on file with the office for the date of service specified on the detailed patient bill.”