Atlanta system 1st in US to face CMS fines for price transparency violations

Atlanta-based Northside Hospital is the first health system in the nation to be fined by CMS for violating federal price transparency laws, CMS told Becker's. 

Northside was fined more than $1 million, according to CMS. Northside Hospital Atlanta, the health system's flagship facility, was fined $883,180, according to CMS. Northside Hospital Cherokee in Canton, Ga., was fined $214,320.

CMS said Northside Hospital Atlanta didn't have a searchable list for consumers posted in a prominent manner that clearly identified the location of the hospital concerned, according to the report. CMS said "no consumer-friendly list of standard charges was found," for Northside Hospital Cherokee. 

Northside told the Atlanta Journal-Constitution last year that the information required by the federal government would not actually be useful to consumers because it lacked context, according to the report. Prices paid by patients can vary depending on factors like insurance contract negotiations. 

CMS also said Northside didn't include all required services in a machine-readable file, and services weren't included in a single file, according to the report. 

As of early June, CMS has issued about 352 warning notices to hospitals that were found out of compliance with price transparency rules, which went into effect Jan. 1, 2021. CMS has also sent 157 requests for a corrective action plan to hospitals that received a warning and had not made any corrections. There have been 171 hospitals who have had their cases closed after addressing issues.

CMS told Becker's the Northside hospitals received a notice and a corrective action plan request, but neither hospital submitted a plan, and both remained noncompliant.

"CMS expects hospitals to comply with the hospital price transparency regulations that require providing clear, accessible pricing information online about the items and services they provide," Meena Seshamani, MD, PhD, CMS deputy administrator and director of the Center for Medicare, told Becker's. "This enforcement action affirms the Biden-Harris administration's commitment to making healthcare pricing information accessible to people across the country, and we are committed to ensuring that consumers have the information they need to make fully informed decisions regarding their healthcare."

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