Is CMS Auditing For Price Transparency?

Last year the hospital industry faced major changes to the availability and accessibility of their prices. Now that 2021 is here, and the new CMS rules are officially in effect, CMS plans to audit how successfully the industry achieved compliance.

According to the CMS website they have already selected hospitals for their initial audits. We’re not sure how hospitals were selected for audits, or what criteria went into CMS’ decisions, but we do know that some of the audits will probe specific complaints and patients can submit complaints on the CMS website. Additionally, we don’t yet know if hospitals found outside of compliance have been informed or fined.

Because there’s no single place to find the information, making sure every hospital is compliant and up-to-date may be a laborious, if not impossible task. That won’t stop CMS from investigating individual hospitals and systems, especially if they suspect, or have a report, that they are not compliant.

Noncompliance isn’t without risk. Should a hospital fail to post their prices, or decide not to do so, they could face a fine of $300 per day. CMS’ website states that there will be several steps before this, however, including a written warning notice and requesting an action plan.

Of course, hospitals can appeal before a judge, and have 30 days to do so. It is up to each facilities’ administration to determine how much risk they are willing to take.

What does this mean for you and your organization? Well, it depends on how much work you’ve already done. How close are you to compliance? What work still needs to be done?

We can help! We have experience with the types of files CMS requires as well as building price estimator tools. Give us a call at 888.779.5663 or see our price transparency resources here.

Comments (0)

Leave a Reply

XHTML: You can use these tags: <a href="" title=""> <abbr title=""> <acronym title=""> <b> <blockquote cite=""> <cite> <code> <del datetime=""> <em> <i> <q cite=""> <s> <strike> <strong>