The Centers for Medicare & Medicaid Services (CMS) has updated its hospital price transparency enforcement processes in several areas.
CMS will now require hospitals to be in full compliance with the price transparency regulation within 90 days from when CMS issues a corrective action plan (CAP) request. Previously, hospitals were permitted to propose a completion date for CMS approval. Hospitals that are out of compliance with the price transparency regulation will still need to submit a CAP within 45 days from when the CAP request is issued by CMS.
CMS will now automatically impose civil monetary penalties (CMPs) on hospitals that fail to submit a CAP at the end of the 45-day CAP submission deadline. Before imposing the CMP, CMS will re-review the hospital’s files to determine whether any of the violations cited in the CAP request continue to exist. If violations are found, it will impose a CMP. For hospitals that submit a CAP by the 45-day CAP submission deadline but fail to comply with the terms of that CAP by the end of the 90-day deadline, CMS will re-review the hospital’s files to determine whether any of the violations cited in the CAP request continue to exist. If it is determined that violations still exist, CMS will impose an automatic CMP.
To streamline the compliance process, CMS will no longer issue a warning notice to hospitals that have not made any attempt to satisfy price transparency requirements and will instead immediately request that the hospital submit a CAP. Currently, CMS issues a warning notice before issuing CAP requests.
The enforcement updates will shorten the average time by which hospitals must come into compliance with the price transparency requirements after a deficiency is identified to no more than 180 days, or 90 days for cases with no warning notice.