CMS Doubles Down on Hospital Price Transparency in New Proposed Rule

The Centers for Medicare & Medicaid Services proposed a new rule last week that would impose higher penalties for large hospitals that fail to comply with price transparency rules.

From U.S. Department of Health and Human Services Secretary Xavier Becerra:

With today’s proposed rule, we are simply showing hospitals through stiffer penalties: Concealing the costs of services and procedures will not be tolerated by this administration.

Only 5.6% of hospitals are currently compliant with the Trump era price transparency rule since its implementation began on January 1, according to a report on 500 randomly selected hospitals conducted by PatientRightsAdvocate.org. The price transparency rule requires hospitals to public machine readable files on their websites containing gross charges, payer-specific negotiated charges, discounted cash prices and at least 300 shoppable services that a patient may schedule in advance, Revcycle Intelligence reports.

According to a CMS press release on the proposed rule, the rule directly follows President Joe Biden’s Competition Executive Order, and the agency is doubling down on efforts to increase price transparency and hold hospitals responsible for failing to post the requisite information.

The Wall Street Journal reports that hospital groups are unhappy with the proposal, with the American Hospital Association calling the higher penalties “concerning” and that they find the original transparency rules “uncertain”. From Bruce Siegel, CEO of America’s Essential Hospitals:

More stringent penalties for noncompliance with rules whose potential effects even the administration cannot quantify is the wrong direction for this policy.