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Tuesday May 18, 2021  |  Shawn Wiese, Director, Product Regulatory Compliance

Warning Letters Are in The Mail After CMS Price Transparency Audits

Warning Letters Mail CMS After Price Transparency Audits EHR

Act now to avoid non-compliance and potential fines.

The Centers for Medicare and Medicaid Services’ (CMS) Price Transparency Rule, which became effective January 2021, requires licensed hospitals to make public a list of standard charges in a machine-readable format along with a second list of “300 shoppable items.” CMS has now begun auditing hospitals’ websites and price transparency compliance submissions. Following the audits, CMS has also begun to send warning letters, moving forward with Price Transparency enforcement.

How Does CMS Define Price Transparency Compliance?

In March of 2021, HealthAffairs.org conducted an analysis of the top 100 United States hospitals for compliance to the new rule. HealthAffairs.org found 60 percent of the hospitals surveyed were non-compliant with the rule’s basic requirements.

Compliance with the rule is not as straight forward as it may sound. For each chargeable item, hospitals must list gross charges, each payor’s contracted price, a discounted cash price, and a de-identified minimum and maximum negotiated price. This list must also be actively maintained.

Hospitals that receive warnings are given a 90-day window to address shortcomings. Depending on the hospital’s response, CMS may close its inquiry, deliver a second warning letter, or request a corrective action plan from the hospital. Civil Monetary Penalties of up to $300 a day could be imposed for non-compliance.

If you have adopted the MEDHOST Price Transparency solution, you can be confident that our solution complies with the regulations and meets all requirements. Our solution has been designed and implemented in accordance with CMS’s Final Rule (CMS-1717-F2) and guidance provided on the CMS Hospital Price Transparency website.

However, if your hospital or healthcare organization is still working towards compliance, now is the time to make price transparency a priority. For further details on how we can help you meet the Price Transparency Rule requirements, contact your MEDHOST Account Executive or please reach out to us at inquiries@medhost.com or call 1.800.383.6278.

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