Insights

CMS: Post required price transparency information or face penalties of $300 per day


CMS has started issuing its first round of warning letters to hospitals not in compliance with the hospital price disclosure rule.

The rule, which took effect Jan. 1, requires hospitals to:

  • Publish clear, accessible pricing information for 300 shoppable services. This information must be published online, require no login or personal health information for access, and be offered in a consumer-friendly format
  • Publish a machine-readable file including rates for all services (not just shoppable services)

 The warning letters now being issued by CMS will provide hospitals with 90 days to address the findings in the noncompliance letter. The price transparency rule explains that, if a hospital is noncompliant, the agency may take the following action:

  • Request a corrective action plan from the hospital
  • Assess a civil monetary penalty of up to $300 per day
  • Publicize the penalty on a CMS website

Hospitals not in compliance with the rule not only face the above consequences as laid out by CMS but will find themselves behind in a crucial area of healthcare consumerism. From a consumer’s perspective, hospital pricing information helps patients and caregivers know what to expect as they make informed decisions about financial arrangements. As hospitals strive to deliver superior patient experiences, price transparency is a critical part of that delivery. It removes a lot of the confusion related to estimated costs of services before care is delivered. Essentially, a hospital’s ability to communicate pricing information allows patients and caregivers to effectively research and compare healthcare costs, which improves quality and health literacy.

By Moses Landon,
Vice President, Patient Access Operations
Ensemble Health Partners

These materials are for general informational purposes only. These materials do not, and are not intended to, constitute legal or compliance advice, and you should not act or refrain from acting based on any information provided in these materials. Please consult with your own legal counsel or compliance professional regards specific legal or compliance questions you have.