CMS finalizes fee hikes for hospital price transparency requirements

Price transparency
The Centers for Medicare & Medicaid Services finalized its annual Outpatient Prospective Payment System rule late Tuesday. (Getty/utah778)

Beginning Jan. 1, the Biden administration will increase the penalty for certain hospitals that are not in compliance with its hospital price transparency requirements.

The Centers for Medicare & Medicaid Services (CMS) announced late Tuesday that it will set a minimum civil monetary penalty of $300 per day for hospitals with 30 or fewer beds. For hospitals with more than 30 beds, they will be charged $10 per bed per day, which will cap at $5,500 daily.

CMS outlined the fees in its final Outpatient Prospective Payment System (OPPS) rule for 2022.

Based on the daily fees, the minimum amount for a year of noncompliance would be $109,500 per hospital to a maximum of $2,007,500 per hospital. The agency said it is committed to assisting hospitals in getting into compliance with the regulation.

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In a statement, Stacey Hughes, executive vice president for the American Hospital Association (AHA), said hospitals are equally committed to ensuring patients have access to the financial data they need. However, the group has concerns about the fee increases.

"We are very concerned about the significant increase in penalties for non-compliance with the hospital price transparency rule, particularly in light of the many demands placed on hospitals over the past 18 months, including both responding to COVID-19, as well as preparing to implement additional, overlapping price transparency policies," Hughes said.

CMS proposed higher penalties earlier this year, much to an outcry from providers. The agency argued it will help increase participation, but providers said there isn't evidence that the current fees prevent participation on the price transparency requirements.

A study released in June found that even high-revenue hospitals were struggling to comply with the rule.

The final payment rule also extends cuts to the 340B drug discount program, which has drawn ire for several years in a row.

In a statement, 340B Health CEO Maureen Testoni said the continued payment cuts make it harder for hospitals to provide care to people in need.

"We are deeply disappointed that CMS will be continuing this harmful and inequitable Medicare payment policy for many safety-net hospitals next calendar year," Testoni said.

The AHA also slammed the extended 340B cuts.