May 7, 2021

Dear Colleagues,

CMS sent out its first round of price transparency non-compliance letters last month.  CMS waited 3 months after the implementation deadline to give hospitals a little breathing room to meet the new requirements.

Hospitals will have 90 days to address the findings in the noncompliance letter from CMS. A common non-compliance issue is that hospitals are only showing the line-item price for outpatient surgeries and not complying with this language:

For example, a hospital posts its line-item price for cataract surgery (CPT 66984) as $2,500.  However, when they receive the final bill that includes O.R. time, supplies, pharmacy, etc., the bill will be closer to $5,000, and the patient is furious.

CMS said that if a hospital fails to meet compliance within 90 days of receiving the letter, CMS will make the name of the hospital public on its website and start the $300/day fine.  For larger hospitals, the $300/day fine isn't a deterrent.  However, being listed as a price transparency offender on CMS's website is a big deal.  We still remember the days when CMS first issued its star quality ratings and CEOs were fired when they were issued a 1-star rating from CMS.

If your hospital received a letter from CMS or is at risk of receiving a letter, I would encourage you to schedule a quick call with me.  We can help you meet compliance within a few weeks and our patient cost estimator is the most consumer-friendly tool on the market.  Just ask Shark Tank's Mr. Wonderful or Apple Co-Founder, Steve Wozniak.  See for yourself, with one of our installations at Elbert Memorial Hospital.


Rick Louie
Managing Director
Hospital Pricing Specialists LLC

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