More than 500 hospitals falling short on price transparency requirements have received warnings from the federal government since April, with more “likely” to receive similar notices soon, the AP reported Tuesday morning.
The outlet’s report cited an unnamed “senior administration official” who shared a list of 519 nationwide hospitals that recently received either a warning notice or a Corrective Action Plan (CAP) request.
The former is an initial 90-day warning from the Centers for Medicare and Medicaid Services with instructions to correct any deficiencies, while the latter is a subsequent 45-day deadline for a hospital to submit a more concrete plan to address its compliance deficiencies.
For hospitals that do not come into compliance following these, CMS issues a civil monetary penalty that scales with bed count. These can run as high as $5,500 per day, or over $2 million per year. Twenty-eight hospitals have been issued civil monetary penalty notices to date, according to CMS.
Among the list of warned hospitals obtained by the AP, Texas led other states with 42 notified facilities, followed by 38 in California, 34 in Indiana and 27 in Louisiana.
The outlet’s source said the administration is planning to ramp up its enforcement of price transparency requirements, which will likely include more warnings for out-of-compliance hospitals.
Such policies began during the tail end of the first Trump administration and brought into effect under President Joe Biden, though President Donald Trump, his officials and prominent Republican lawmakers have signaled interest in taking another crack as a response to widespread frustration with healthcare pricing. That type of increased scrutiny extends to the payer side of the fence as well, having been called out explicitly in the president’s “Great Healthcare Plan” and proposed rulemaking by CMS last December.
To date, experts say there’s little evidence the available pricing data has been used at the patient level, though payers and providers themselves have found ample reason to dig into the data during negotiations.
(Fierce Healthcare has reached out to CMS to confirm the warning letters, and will update this story with any response.)