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CMS Updates Hospital Price Transparency Enforcement Procedures

The Centers for Medicare & Medicaid Services (CMS) on April 26 announced enforcement process changes for the hospital price transparency rule to increase compliance with rule requirements. 

Since January 2021, the hospital price transparency rule has required hospitals to make their standard charges public via machine-readable file or shoppable services list/price estimators for consumers. 

To ensure compliance, CMS audits a sample of hospitals, in addition to investigating submitted complaints. Currently, CMS issues warning notices to noncompliant hospitals before requesting them to submit a corrective action plan (CAP). Further noncompliance may result in civil monetary penalties (CMPs). CMS offers technical assistance throughout the compliance process, according to the agency. 

As of April 2023, CMS has issued more than 730 warning notices and 269 CAP requestsnonc. CMS has imposed CMPs on four hospitals for noncompliance. 

CMS intends to increase compliance by updating the enforcement procedures, including:

  • Requiring noncompliant hospitals to submit a CAP within 45 days of CAP request issuance. Failure to submit by the deadline will result in an automatic CMP. 
  • Requiring hospitals to comply fully with the hospital price transparency regulation within 90 days of CAP issuance. Failure to comply fully will result in an automatic CMP. 
  • Removing warning notices from the compliance process. CMS will immediately issue CAP requests to hospitals that have not attempted to comply.  

Contact Senior Director of Policy Erin O’Malley at eomalley@essentialhospitals.org or 202.585.0127 with questions.

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About the Author

Faridat Animashaun is a policy analyst at America's Essential Hospitals.

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