Bipartisan Letter from U.S. Senators Sent to CMS for Increased Price Transparency Enforcement
Earlier this week, Senator Mike Braun (R-Ind.) and Senator Maggie Hassan (D-N.H.) wrote a letter to CMS asking for stricter enforcement of price transparency rules. In addition, the Republican and Democrat Senators asked for specific information to determine the activity of CMS enforcement to date.
CLAIM THAT CMS NOT AUDITING HOSPITALS ACCORDING TO ALL REQUIREMENTS
"Hospitals deemed compliant have engaged in practices that do not meet the rule’s intent, including providing incomplete information... The hospitals engaging in these practices should not be considered compliant with the law"
SENATORS REQUESTING INFORMATION TO DETERMINE IF CMS IS DOING PROPER AUDITS
We respectfully request that you provide to us no later than 5 p.m. on Friday, October 1st, 2021, the following information:
The number of hospitals currently subject to the Price Transparency Rule;
Of these hospitals subject to the rule:
The number of hospitals that have received warning letters and/or correction action plans (CAP) from CMS for non-compliance (preferably by state);
The number of responses CMS received from non-compliant hospitals (preferably by state), and a description sufficient to help Congress understand either the improvement that is underway, or the work that remains to be done;
The number of hospitals that have been issued a civil monetary penalty by CMS;
A description of how CMS is auditing compliance with warning letters and/or CAPs;
The date by which CMS expects to issue its first civil monetary penalty for non-compliance;
A description of how CMS informs Congress and the American people about which hospitals are fully compliant (or not) with efforts to increase transparency of health care pricing.
If your hospital needs help with price transparency compliance, please do not hesitate to contact us. We can help your organization fulfill the patient cost estimator piece and/or the machine readable file requirement. Some of our clients rely on their EHR vendor for the cost estimator and use HPS to create the machine readable file.
A non-profit called Patient Rights Advocate (PRA) randomly surveyed 500 hospitals and found only 5.6% of the hospitals to be compliant. Among the compliant hospitals, one of ours was on the list. We apply the same methodology among all of our price transparency clients. Click here to view the full PRA report: