A new federal hospital price transparency rule that took effect on January 1, 2021, requires hospitals to post all prices for services online in an easily accessible format. However, a report recently released by PatientRightsAdvocate.org found that 94.4% of hospitals were not in compliance with the rule, because one or more price transparency requirements were not being met.
The rule was created under the Affordable Care Act. The PatientRightsAdvocate.org report found that most hospitals were not posting, or were posting incompletely, the negotiated prices associated with all of the payers and plans accepted by the hospital. The second most common violation was failing to publish the hospital’s full list of discounted cash prices.
In April and May of this year, the Centers for Medicare & Medicaid Services (CMS) sent out warning letters to hospitals that it found were violating the rule. Violators were given a 90-day period to come into compliance, so one would expect to see some follow-up enforcement soon.
In the 2022 Medicare Hospital Outpatient Prospective Payment System proposed rule released on July 19, CMS proposed increasing the penalty for noncompliant hospitals from a flat $300 per day to $10 per bed per day, up to a maximum of $5,500 a day. CMS’s press release on the proposed rule states, “CMS takes seriously concerns it has heard from consumers that hospitals are not making clear, accessible pricing information available online, as they have been required to do since January 1, 2021.”