Avoid CMS hospital price transparency penalties, empower patients, and increase collections

Did you receive a price transparency non-compliance letter from the Centers for Medicare and Medicaid Services (CMS)? Letters were first issued the week of April 19 and hospitals have 90-days to take corrective action and you may not be alone.

While many hospitals have spent more than a year now focusing on COVID-19-related efforts, adding CMS’s price transparency rule on top of it can certainly feel overwhelming. In fact, back on January 22, 2021, Becker’s Hospital Review posted this article stating, “The 20 largest hospitals in the country all have published some type of pricing information on their websites, but not all are in complete compliance with CMS’ new price transparency rules…”

Then, again on June 14, 2021, JAMA Internal Medicine published a report conducted by researchers from Harvard Medical School, stating that of the nation’s top 100 highest gross revenue hospitals, 83 were non-compliant in at least one major area of the rule.

In addition, the CMS website on hospital price transparency also states that, “…in addition to investigating complaints that are submitted to CMS and reviewing analyses of non-compliance, hospitals may face civil monetary penalties for noncompliance.” And the North Dakota Hospital Association also published an article on May 4, 2021, stating, “CMS will identify on the agency’s website hospitals that remain out of compliance and receive a civil monetary penalty.” CMS also provides a place directly on this same website to submit a complaint if they feel a hospital has not posted online pricing.

If your facility needs assistance meeting compliance in this area, SSI can help. Learn about SSI’s Hospital Price Transparency software.

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You can also Request a Demo and we’ll set aside time to speak with you directly “live” on the Web to review your needs, understand your nuances, and suggest a pathway to compliance that makes the most sense for you and your organization.

What is the CMS Hospital Price Transparency rule? The CMS hospital price transparency rule went into effect January 1, 2021 and requires hospitals to post prices for 300 “shoppable” services—including their negotiated rates with commercial health plans—and produce a machine-readable file of standard charges for all hospital items and services. This gives patients improved visibility into estimated costs associated with items or services a hospital provides and it allows hospitals to share estimates with patients before a procedure occurs. Depending on additional strategies implemented, hospitals may also see an increase in up front patient payments by meeting the requirements of this rule as well.

Additional Resources:

SSI Webinar on Hospital Price Transparency (includes demonstration of SSI’s software solution)
To access the webinar, you must be logged in to the SSI Client Website. If you’re a prospective client and would like to watch this video, Request a Demo, provide your information, and we’ll confirm your identity and send you the link.

  • Available to current SSI clients here
  • Available to prospective clients by completing this form so we can verify you work directly for a hospital organization

CMS Hospital Price Transparency information for hospitals
CMS Hospital Price Transparency information for consumers