CMS' price transparency enforcement 'lukewarm,' Johns Hopkins professor says

CMS' enforcement of its hospital price transparency law is "lukewarm," and the agency needs to get tougher, Johns Hopkins University professor of accounting and health policy and management Ge Bai, PhD, told USA Today in an Aug. 9 report. 

Since the transparency law went into effect in January 2021, only two hospitals have been fined for violations. Dr. Bai, an expert on healthcare prices, told the news outlet CMS is "not sending a strong signal to the market that they are taking this seriously."

"The hospitals are taking their cue from CMS," she said. "They are thinking, 'How likely is [CMS] going to pick me?'"

CMS issued its first fines in June to two hospitals in the Atlanta-based Northside Hospital system. 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.

As of late July, CMS has issued 368 warnings to hospitals that they had not complied with price transparency requirements, according to the report. CMS has also sent 188 requests for a corrective action plan to hospitals that received a warning and had not made corrections. CMS cleared 204 hospitals that fixed cited issues. 

"We are encouraged by the significant increase in hospital compliance that we have witnessed since implementation of the regulations last year, and we are committed to working with hospitals through the enforcement process to continue to improve hospital compliance," CMS said in a statement to USA Today.

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