Hospitals get 1st CMS warning on price transparency failure

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CMS has started issuing its first round of warning letters to hospitals not in compliance with the hospital price disclosure rule, a CMS spokesperson confirmed to Becker's May 5. 

The CMS final 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. 

CMS said it began proactive audits of hospital websites and reviewed complaints submitted to its website after Jan. 1, but didn't issue its first round of warning letters until April. 

Hospitals will have 90 days to address the findings in the noncompliance letter from CMS. The agency will then re-review upon expiration of that 90-day window. If the hospital is still not in compliance, it may receive a second warning letter or it may be sent a request for a corrective action plan, CMS said. 

The price transparency rule indicates 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. 

CMS said that while the rule says that once a monetary penalty is issued, it will make the name of the hospital public on its website, "releasing this information prematurely could identify hospitals that have already taken corrective actions and come into compliance after issuance of a warning letter."

As a result, "CMS does not make the list of noncompliant hospitals receiving warning letters available to the public," a spokesperson told Becker's. 

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