April 5, 2022

CMS issues warnings on price transparency to ‘about’ 345 hospitals

By: Tarsilla Moura

Editor's Note

The Centers for Medicare & Medicaid Services (CMS) told Becker’s that as of March 2022, it has issued “‘about 345’ warning notices to hospitals noncompliant with its price transparency regulations,” Becker’s Hospital CFO Report April 4 reports.

CMS’ price transparency rule went into effect on January 1, 2021; was re-enforced by the Biden Administration in July 2021; and is set to become law in July 2022. According to Becker’s, since January 2021, CMS has made “136 corrective action plan requests to hospitals” that have received warning notices but have not followed through with corrective measures. Becker’s further reported that another 124 hospitals have addressed citations, and that CMS has so far not issued any penalties for noncompliance, the maximum of which is $2 million.

In February, OR Manager reported on the “Semi-Annual Hospital Price Transparency Compliance Report,” which found that only 14.3% of 1,000 randomly selected hospitals seem to be complying with the CMS price transparency rule.

The rule essentially requires health systems and health insurance issuers to publicly disclose negotiated prices and historical payments for all covered items and services, as well as disclose cost-sharing information upon request. “CMS has the authority to request a corrective action plan if it finds that a hospital is not compliant with one or more of the requirements of the rule … [and] can issue a civil monetary penalty if a hospital does not respond to its request,” Becker’s informed.

CMS will publicly list hospitals that have received penalties on its website, the agency told Becker’s.

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