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CMS to Begin Monitoring Compliance with Price Transparency Requirements in January

For CEOs, CFOs, government relations staff

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The Centers for Medicare & Medicaid Services (CMS) has announced it plans to conduct an audit sample of hospitals’ compliance with the hospital price transparency requirements beginning in January.

The requirements are effective Jan. 1, 2021, and mandate that hospitals make their third-party negotiated rates for items and services publicly available online in two ways. In order to comply, hospitals must post the following information on their websites: 

  • A comprehensive machine-readable file that includes all standard charges for all hospital items and services 
  • A searchable display of standard charges for at least 300 “shoppable” services 

If CMS determines that a hospital is non-compliant with its price transparency requirements, it may take the following actions: 

  • Provide a written warning notice to the hospital of the specific violation(s) 
  • Request a Corrective Action Plan (CAP) if noncompliance constitutes a material violation of one or more requirements 
  • Impose a civil monetary penalty not in excess of $300 per day and publicize the penalty on a CMS website if the hospital fails to respond to its request to submit a CAP or comply with the requirements of a CAP