CMS sent out warnings to hospitals failing at price transparency. Some still aren’t sure where they land

by Dave Muoio | May 10, 2021 

The Centers for Medicare & Medicaid Services has sent its first wave of warning letters out to hospitals breaking federal rules requiring them to disclose payer-negotiated prices, a spokesperson for the agency confirmed.

CMS has been auditing hospitals’ websites and complaint submissions since the rule went into effect on January 1 and began sending out warnings in April, the spokesperson said.

Hospitals that received the warning are given a 90-day window to address shortcomings outlined in the letter. From there, the agency may close its inquiry, deliver a second warning letter or request a corrective action plan from the hospital.

The final rule specifies that facilities receiving a civil monetary penalty will also be publicly named on CMS’ website. The agency said it has yet to reach this point with its enforcement, as prematurely releasing the names of those hospitals could harm organizations that have already updated their online pricing information or are in the process of doing so.

The Hospital Price Transparency final rule requires hospitals to publish a machine-readable file online that outlines their payer-negotiated payment rates. It also requires hospitals to provide a tool that allows consumers to search and view the prices of 300 shoppable medical services.


Chris J. Stewart

Chris currently serves as President and CEO of Surgio Health. Chris has close to 20 years of healthcare management experience, with an infinity to improve healthcare delivery through the development and implementation of innovative solutions that result in improved efficiencies, reduction of unnecessary financial & clinical variation, and help achieve better patient outcomes. Previously, Chris was assistant vice president and business unit leader for HPG/HCA. He has presented at numerous healthcare forums on topics that include disruptive innovation, physician engagement, shifting reimbursement models, cost per clinical episode and the future of supply chain delivery.

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