A bipartisan group of lawmakers raised concerns about the lack of compliance among hospitals to post prices for services online. A new rule requiring them to do so went into effect January 1 but compliance is spotty. The group called on HHS to step up oversight of the price transparency rule in a letter to HHS Secretary Xavier Becerra. The letter urged the department to conduct regular audits of hospitals and to revisit available enforcement tools, including the amount of the civil penalty for noncompliance, which is just $300 per day.
Letter and Related
The letter notes that the Hospital Price Transparency Final Rule requires hospitals to make public a machine readable file containing a list of all the standard charges for all items and services, and to display charges for the hospital’s 300 most shoppable services in a consumer-friendly format. Under the final rule, hospitals are required to make public the gross charges, the discount cash price, the payer-specific negotiated charges, and the de-identified minimum and maximum negotiated charges for all items and services.
But the letter points out a Health Affairs study of hospital compliance which found 65 of the nation’s largest 100 hospitals were “unambiguously non-compliant” between January and February of 2021. 18% of hospitals either did not post any files or provided links to databases that were not downloadable. 82% of them did not include the payer-specific negotiated rates or were in some other ways noncompliant. According to the study, 22% of the hospitals generally were compliant with the rule’s requirements.
The letter cites support for HHS enforcement to make sure price transparency is being followed. The letter writes, “we urge HHS to enforce the final rule to ensure hospitals are fully compliant with the disclosure requirements so that patients can readily access the price information for all items and services in an easy-to-use-format.” The letter further asks HHS to revisit its enforcement tools, including civil penalties, and to conduct regular audits of hospitals for compliance. They additionally requested a briefing on the implementation of the rule and audits.
It should be noted, earlier this year, CMS said it was conducting an audit of a small sample of hospitals and investigating complaints of noncompliance. The agency did not share any findings from those audits or complaints with the press.
Despite fierce pushback from the hospital lobby, the rule went into effect this year. The American Hospital Association went to court seeking to block the rule. It was ultimately unsuccessful in its bid, and attempted a last ditch effort to halt implementation in the final days before the rule took hold.