Jul 20, 2021
The Centers for Medicare and Medicaid Services (CMS) proposes to increase the penalty for some hospitals that don’t comply with the Hospital Price Transparency Final Rule. There is a wide variation in hospital prices even within the same hospital or the same system, depending on what each insurance plan has negotiated, CMS reports.
Eighty-three percent of 100 randomly chosen hospitals don’t comply with at least one of the requirements of the final rule, according to recent research published in JAMA Internal Medicine. Also, about half the hospitals offer the required consumer-friendly cost estimator and only 33% provide payer-specific negotiated rates.
CMS proposes a minimum civil monetary penalty of $300 per day for smaller hospitals with a bed count of 30 or fewer and a penalty of $10/bed/day for hospitals with a bed count of more than 30, not to exceed a daily maximum of $5,500.
For a full calendar year of noncompliance, the minimum total penalty would be $109,500 per hospital, and the maximum would be $2,007,500 per hospital.