CMS Issues First Round of Price Transparency Warnings
The price transparency rule, which went into effect January 1, 2021, requires hospitals to publish a machine-readable filed that outlines their payer-negotiated payment rates. Also required as part of the rule, hospitals must provide a tool that allows consumers to search and view the prices of 300 shoppable medical services. The Centers for Medicare and Medicaid Services (CMS) has been conducting audits of hospitals’ websites as well as reviewing complaint submissions since the rule went into effect. CMS began sending out warning letters to those hospitals they have found to be noncompliant of the federal rule. Hospitals who receive a warning have a 90-day period to address the deficiencies outlined in the letter. After the 90-day period, CMS may close its inquiry, deliver a second warning letter, or request a corrective action plan from the hospital. Failing to comply with the rules could result in a fine for the offending hospital of up to $300 per day.
While there has been overall resistance in implementing the price transparency rule, hospitals have also cited difficulty implementing the requirements of the rule based on the ambiguity of the rules’ language, difficulty with the machine- readable file requirements, or the cost to the hospital to implement all aspects of the rule. CMS has yet to reach the point in The Hospital Price Transparency final ruling which specifies that facilities that incur a monetary penalty will also be publicly named on CMS’ website, however, they will continue to monitor facilities and enact the enforcement process as necessary with noncompliant hospitals. To read the entire article, click here.
