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Price Transparency Audits to Begin in 2021

Analysis  |  By Revenue Cycle Advisor  
   December 25, 2020

Organizations may refer to CMS' Hospital Price Transparency website for more information and resources.

A version of this article was first published December 23, 2020, by HCPro's Revenue Cycle Advisor, a sibling publication to HealthLeaders.

CMS will begin auditing hospitals for compliance with the Hospital Price Transparency final rule in January 2021, according to a December 18 MLN Connects special edition article.

CMS will audit a sample of hospitals and investigate complaints of noncompliance submitted to the agency. If a hospital is not in compliance, CMS may take the following actions:

  • Warn the hospital in writing of the specific violations
  • Require a corrective action plan
  • Impose a civil monetary penalty and publicize the penalty on a CMS website

Additional information on monitoring and enforcement can be found at 45 CFR Subpart C.

Organizations may refer to CMS’ Hospital Price Transparency website for more information and resources including FAQs, a compliance checklist, and technical information on creating a machine-readable file and a consumer-friendly display.

Although the American Hospital Association is challenging the final rule in court and has asked President-elect Biden to rescind certain requirements, organizations must still be in compliance with the final rule by January 1, 2021.

Revenue Cycle Advisor combines all of HCPro's Medicare regulatory and reimbursement resources into one handy and easy-to-access portal. News is not just repeated from other sources. It is analyzed by our Medicare experts so professionals can comprehend any new rule and regulatory updates thoroughly. Learn more.

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