CMS holding off on hospital price disclosure penalties

CMS has refrained from penalizing providers who haven't complied with its price transparency rule, Bloomberg Law reported Aug. 16. 

CMS said that it began sending warning letters to hospitals not in compliance with the regulation in April. The agency told Bloomberg that it had sent about 165 warning letters by mid-July. 

Hospitals have 90 days to address the violations before CMS decides whether additional compliance actions are necessary. 

"CMS intends to continue its monitoring and enforcement activities and will issue additional warning letters on a monthly basis going forward, as necessary," a CMS spokesperson told Bloomberg. 

The CMS spokesperson confirmed that the agency has not issued any fines to hospitals.

The CMS final price transparency rule, which took effect Jan. 1, aims to make hospital pricing information readily available to patients to compare costs and make more informed healthcare decisions. To aid with this, hospitals in the U.S. are required to post both a machine-readable file with the negotiated rates for all items and services and display the prices of 300 shoppable services in a consumer-friendly format. 

The price transparency rule states that if a hospital is noncompliant, the agency may request a corrective action plan, assess a civil monetary penalty of up to $300 per day or publicize the penalty on a CMS website.

A recent analysis of 500 hospitals conducted by the nonprofit Patient Rights Advocate found that 94.4 percent of hospitals haven’t met at least one of the requirements since the rule took effect.

To boost compliance, CMS has proposed increasing the minimum fine for price transparency violations to up to $2 million per year. Hospitals with more than 30 beds in violation of the rule would pay $10 per day for each bed, up to $5,500 per day. Hospitals with 30 beds or fewer would continue to pay up to $300 per day. This would make the annual penalty at least $109,500, or as high as $2 million a year for large hospitals that fail to make prices public. 

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