CMS to raise penalties related to enforce price transparency
CMS to raise penalties related to enforce price transparency
The agency is also moving forward with a plan to stop the elimination of the Medicare inpatient-only list, which is a win for hospitals.
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CMS is increasing the penalty for hospitals that don't post their prices online to be as much as $2 million a year for larger facilities
In a fact sheet for the 2022 Outpatient Prospective Payment System, the agency said its "initial analysis strongly suggests there is sub-optimal compliance" with the price transparency requirements. The original fee was $300 a day for all hospitals, regardless of size.
Starting next year, noncompliant hospitals with 30 beds or fewer will be fined $300 a day and larger hospitals will be fined $10 per bed, per day, up to $5,500 a day. CMS is also requiring that the machine-readable files with pricing information be accessible to automated searches and direct downloads. Some hospitals had reportedly been using hard-to-access files as a tactic for obscuring information.
The American Hospital Association said it was "very concerned" about the change, "particularly in light of the many demands placed on hospitals over the past 18 months, including both responding to COVID-19, as well as preparing to implement additional, overlapping price transparency policies."
Research has shown that compliance with the price transparency requirements is dismal, and experts said it was unlikely to improve without more of a financial hit for noncompliance. A JAMA study published in June found that of 100 randomly sampled hospitals and 100 of the highest-earning, 83% were noncompliant.
That backed up an earlier study from JAMA Network Open that noted a bit more than half of the nearly 5,300 hospitals researchers studied did not have a chargemaster in a machine-readable format as the law requires. Another Health Affairs study reported similar findings.