CMS Continues Its Focus on Hospital Pricing Transparency

Steptoe & Johnson PLLC

The Centers for Medicare & Medicaid Services’ (“CMS”) message this year has been consistent – hospitals need to comply with CMS’ Hospital Transparency Rule. This rule requires hospitals and health systems to disclose a comprehensive list of standard charges for all items and services and a consumer-friendly list of prices associated with a narrower “shoppable” set of services. In an effort to increase sluggish compliance, CMS has now proposed significantly increased penalties on hospitals that fail to comply. The proposal would increase the maximum Civil Monetary Penalty (“CMP”) to $2,007,500 for a full year of noncompliance. The maximum daily penalty would increase to $5,500 for hospitals with bed counts greater than 30 and $300 for hospitals with bed counts less than 30.

If accepted, the proposed CMP would become effective January 1, 2022. Hospitals should examine their compliance with the Hospital Transparency Rule and modify their practices to be compliant well in advance of this deadline. 

DISCLAIMER: Because of the generality of this update, the information provided herein may not be applicable in all situations and should not be acted upon without specific legal advice based on particular situations.

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