Attention Call: CMS Issues First Fines to Hospitals for Price Transparency Rule
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CMS handed down their first penalties to two hospitals in Georgia for failing to comply with the price transparency law that went into effect Jan. 1, 2021. The two hospitals were both fined for a lack of readily available standard charges for hospital services online, despite previous warnings.
The amount of both fines was based on the number of days they were noncompliant, and the number of beds was considered as well. The hospitals were fined?$883,180?and?$214,320, respectively.?
Both hospitals must pay the penalty within 60 days.??Non-compliant hospitals can appeal the civil monetary penalty decision by requesting a hearing within 30 days. If they don't pay, the noncompliance fees will continue to accrue until the hospital corrects their pricing information and notifies CMS.
Non-compliance criteria
As part of the Hospital Price Transparency Final Rule, items, services, and medical procedures must be posted online, in one machine-readable file that is "consumer-friendly" The two non-compliant hospitals had neither machine-readable file published digitally, and neither were displayed in a "consumer-friendly" list.
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Both had previously received warning notices, and both received indications for a corrective action plan. One of CMS’s arguments for penalty applicability is that they sent warning notices from May 2021 to January 2022 but none of both hospitals took steps to post online price lists that met the requirements.
CMS’s letters corroborated that during the technical assistance calls, representatives from the hospital "confirmed that the previous violations had not been corrected and, in fact, the hospital system had intentionally removed all previously posted pricing files."
One important factor in CMS’s enforcement strategy is to?post CMPs (penalties) notices?in their?website?and publicly inform and point out, in favor of communities and consumers,?non-compliant?hospitals and?other healthcare providers. CMS has issued 352 warning notices to hospitals who were out of compliance, and 157 "corrective action plan" requests.??(Click here to view?official CMS’s Enforcement Actions website).
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