FinancialHospitalsRegulatory

Final rule ups financial penalties to hospitals that ignore price transparency regulation

Providers speak out against 340B drug pricing cuts of nearly 30%.

November 3, 2021 / Susan Morse, Managing Editor

The Centers for Medicare and Medicaid Services is making modifications to the hospital price transparency regulation designed to increase compliance, after initial analysis strongly suggests there is suboptimal compliance beginning January 1, 2022. CMS released the Medicare Hospital Outpatient Prospective Payment System and Ambulatory Surgical Center Payment System Final Rule on Tuesday.

CMS is increasing the civil monetary penalties to a minimum of $300/day that will apply to smaller hospitals with a bed count of 30 or fewer, and a penalty of $10/bed/day for hospitals with a bed count greater than 30, not to exceed a maximum daily dollar amount of $5,500.

Under this approach, for a full calendar year of noncompliance, the minimum total penalty amount would be $109,500 per hospital, and the maximum total penalty amount would be $2,007,500 per hospital.

WHY THIS MATTERS

This approach to scaling the CMP amount retains the current penalty amount for small hospitals, increases the penalty amount for larger hospitals and affirms the Administration’s commitment to enforcement and public access to pricing information, CMS said.

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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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