CMS ramped up price transparency enforcement in 2023

After fining the first two hospitals for alleged price transparency violations in 2022, CMS fined 12 more in 2023. 

The bed counts of hospitals fined for price transparency violations ranged from more than 550 (Jacksonville, Fla.-based UF Health North) to 25 (Salem, Ark.-based Fulton County Hospital). Seven of the 12 hospitals fined this year have fewer than 100 beds, including five with fewer than 50. 

Fine amounts have ranged from $979,000 for UF Health North to $56,940 for Samaritan Hospital-Albany (N.Y.) Memorial Campus, according to CMS' price transparency enforcement website. CMS levies different civil monetary penalties on hospitals based on the number beds the facility has. Hospitals with 30 or fewer beds can receive a maximum penalty per day of $300. The maximum daily fine for hospitals with at least 31 and up to 550 beds is the number of beds times $10. For hospitals with greater than 550 beds, the maximum daily fine is $5,550. 

Seven of the hospitals fined in 2023 have appealed their penalties, according to CMS' website. Those appeals are under review, and that process appears to take months. In one case, Wichita Falls, Texas-based Kell West Regional Hospital was fined in April and filed an appeal in May, which remains under review. Terry Stagg, Kell West's IT director, told NBC affiliate KFDX on May 4 that the company the hospital paid to handle the posting of standard hospital charges and shoppable services in a consumer-friendly manner did not follow through with that obligation and the hospital has taken care of it on its own. Kell West CEO Jerry Myers, MD, told the news outlet he does not expect any problems with the appeal because CMS has already fully confirmed compliance.

A 13th hospital was fined in 2023 — Washington, D.C.-based Saint Elizabeths Hospital — but CMS rescinded the $677,440 penalty after it was determined the hospital met exception criteria.  

CMS also announced changes to the enforcement process in 2023. In April, CMS unveiled a series of changes it said shortens the average time hospitals have to comply with price transparency requirements to no more than 180 days. In November, CMS said further changes will take effect in 2024. 



Copyright © 2024 Becker's Healthcare. All Rights Reserved. Privacy Policy. Cookie Policy. Linking and Reprinting Policy.

 

Articles We Think You'll Like

 

Featured Whitepapers

Featured Webinars