How CMS Price Transparency Processes Are Changing

April 27, 2023

The federal government is taking steps to ensure compliance with price transparency rules for hospitals, CMS leaders said this week.

On Wednesday, CMS Administrator Chiquita Brooks-Lasure provided an update to lawmakers in the House Energy and Commerce Health Subcommittee on the agency’s price transparency rule and plans to streamline the enforcement process.

“CMS continues to collaborate and work with hospitals and stakeholders to increase and improve compliance with the hospital price transparency requirements,” Brooks-Lasure said in prepared remarks.

Here’s what you need to know:

• Background:  Effective since 2021, CMS’ price transparency rule requires hospitals to establish, update, and make public a list of their standard charges for items and services they provide.
• New changes:  The federal government is looking to enhance its oversight process for the price transparency rule by:
  • Requiring hospitals to be in full compliance with the hospital price transparency regulation within 90 days after CMS requests a corrective action plan
  • Automatically imposing a civil monetary penalty on hospitals that fail to submit a corrective action plan after 45 days
  • Immediately requesting a corrective action plan for facilities that have not made any attempts to satisfy requirements of the transparency rule
• Increasing compliance:  CMS recently sampled hospital websites for compliance and found that 82 percent of hospitals had provided consumer-friendly display criteria that met federal requirements.
• Noteworthy:  As of this month, only four hospitals have received civil monetary penalties for noncompliance, Brooks-Lasure said.
• Quotable:  “Importantly, we have been engaging interested parties, including consumer groups, hospitals, researchers, and other industry experts, to obtain their feedback on the most useful and meaningful ways to display hospital standard charge information,” Brooks-Lasure said.

HAP and Pennsylvania hospitals are committed to increasing transparency around health care costs and quality. Learn more about hospital billing and transparency.

A fact sheet with the latest CMS price transparency rule updates is available online.