CMS Makes Changes to Hospital Price Transparency Enforcement Process

CMS is making changes to the hospital price transparency enforcement process in an effort to increase compliance.

The agency said the changes will shorten the average time that hospitals have to comply with price transparency requirements to no more than 180 days, according to an April 26, 2023 CMS news release.

Five things to know:

  1. CMS is continuing to require hospitals that are out of compliance submit a corrective action plan within 45 days, but will now require hospitals to be in full compliance within 90 days. Currently, CMS allows hospitals to propose a completion date for CMS approval, which can vary.
  2. CMS will now automatically impose fines on hospitals that do not submit a corrective action plan at the end of the 45-day submission deadline. CMS will re-review the hospital’s file to determine whether any of the violations cited in the corrective action plan request continue to exist and, if so, impose a fine.
  3. For hospitals that submit a corrective action plan by the 45-day submission deadline but fail to comply with the terms of the plan by the end of the 90-day deadline, CMS will re-review the hospitals files to determine whether any violations cited continue to exist and, if so, impose an automatic fine.
  4. CMS will no longer issue warning notices to hospitals that do not make any attempt to satisfy the requirements. Currently, CMS does not issue corrective action plans without first issuing a warning notice.
  5. CMS has issued more than 730 warning notices and 269 corrective action plan requests as of April 2023. Four hospitals have been fined for noncompliance. The two most recent fines were issued April 19.

“CMS continues to explore additional ways to ensure that hospitals fully comply with the hospital price transparency requirements, including whether to propose additional changes through rulemaking,” the agency stated in the release.

Read the full release here.