Billing Beat

CMS Begins Enforcement of Hospital Price Transparency Rule

June 3, 2021

The Centers for Medicare and Medicaid Services (CMS) has confirmed that the agency began sending warning letters to hospitals it deems out of compliance with the Hospital Price Transparency Rule in April 2021. This represents the first enforcement action under the Rule since it went into effect on January 1, 2021.

Hospitals that received a written warning were generally given 90 days to address the compliance deficiencies listed in the letter, according to CMS.

The Rule requires hospitals to publish two lists of prices:

  1. A comprehensive, “machine-readable” list of various charges for all items and services.
  2. A consumer-friendly list of prices for a smaller set of “shoppable” services.

Most concerning for many hospitals, both lists must include payer-specific negotiated charges which are typically kept confidential by hospitals and payers alike. The American Hospital Association and other hospital groups unsuccessfully challenged the Rule in court in 2020.

Source: https://www.jdsupra.com/legalnews/cms-begins-enforcement-of-hospital-5573894/

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