Transparency

The Health Care Cost Reduction & Transparency Act

North Carolina’s Health Care Transparency Law and Regulation is intended to improve transparency of the cost of health care provided by hospitals and ambulatory surgical facilities by disclosing the prices for the most frequently reported DRG’s and Outpatient Surgical and Imaging codes. The law requires hospitals to provide an annual data report that includes charges and payment for the top inpatient 100 DRG’s, the 20 most common outpatient surgical procedures and the 20 most common outpatient imaging procedures (as determined by IBM Watson Health). The next submission, due to IBM on Jan. 1, 2019, is required to include 12 months of DRG and outpatient procedure data for the period ending Sept. 30, 2018 for all sites operated by the licensed hospital (or ambulatory surgery center).

Guidance for preparing these reports can be found in the IBM File User Guide, the DHSR website and by logging into Transparency Law/Rule section of NCHA’s website below. There you will also find updated tables for use in accurately reporting Medicaid Supplemental Payment (RCC Transparency Template) and Medicare services.

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North Carolina Healthcare Association

2400 Weston Parkway
Cary, NC 27513
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Main: 919-677-2400
Fax: 919-677-4200

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