On November 2, 2021, CMS published the 2022 Hospital Outpatient Prospective Payment System Final Rule that addressed its previously-proposed penalties for hospital non-compliance with price reporting requirements.
The 2021 Price Transparency Final Rule, effective January 1, 2021, required hospitals to publish their charges based on five categories:
- Gross Charges: non-discounted rates listed in the hospital’s chargemaster
- Discounted Cash Prices: rates for individuals paying cash or cash equivalents
- Payer-Specific Negotiated Charges: rates negotiated with a third-party payer for an item or service
- De-identified Minimum Negotiated Rates: lowest rates negotiated with all third-party payers
- De-identified Maximum Negotiated Rates: highest rates negotiated with all third-party payers
Effective January 1, 2022, hospitals with 30 or fewer beds that are not in compliance with the 2021 Rule face a minimum civil monetary penalty of $300 per day. Hospitals with greater than 30 beds face a penalty of $10 per bed per day. The maximum daily penalty is capped at $5,500 per day.
Annually, the minimum total penalty is $109,500 per hospital; the maximum total penalty is $2,007,500 per hospital.
The display copy of the Final Rule is available here and scheduled for publication in the Federal Register on November 16, 2021.
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