CMS on Tuesday released findings from a 2022 review of 600 hospital websites, reporting that 70% of hospitals are fully compliant with the hospital price transparency rule — an increase from just 27% of hospitals in 2021.

Background

On Jan. 1, 2021, CMS beganenforcing a price transparency rule that requires hospitals to post online "a machine-readable file … that includes all standard charges (including gross charges, discounted cash prices, payer-specific negotiated charges, and de-identified minimum and maximum negotiated charges) for all hospital items and services."

Under the rule, hospitals are also required to publicly post "discounted cash prices, payer-specific negotiated charges, and de-identified minimum and maximum negotiated charges for at least 300 'shoppable' services."

In June 2022, CMS issued its first fines to noncompliant hospitals. Under the law, larger hospitals could face a maximum yearly fine of $2 million, while hospitals with fewer than 30 beds could face a maximum fine of $110,000 for lack of compliance.

Earlier this month, Patient Rights Advocate (PRA) published a report claiming that only 489 hospitals, or 24.5%, of hospitals were fully compliant with the rule as of February 2023, up from 14% in PRA's February 2022 survey.

However, the American Hospital Association (AHA) has argued compliance is much higher than what reports have suggested and that most findings should be taken with a grain of salt.

"As the sole arbiter of compliance, only CMS' review should be taken into consideration when determining whether and how hospitals are complying," said Ariel Levin, senior associate director of policy for AHA, adding that several studies "have misrepresented hospital compliance" by assessing them differently than CMS would.

70% of hospitals are fully compliant with price transparency rules

On Tuesday, Meena Seshamani, CMS' deputy administrator and director, and Douglas Jacobs, CMS' chief transformation officer, released updated findings on hospital compliance with the rule.

To assess hospital compliance, CMS reviewed the websites of 600 hospitals randomly sampled from the Homeland Infrastructure Foundation-Level Data between September and November 2022.

Among the 600 acute care hospitals sampled for the 2022 analysis, 493 hospitals (82%) posted a consumer-friendly display that was compliant with the rule's consumer-friendly display website assessment criteria, 490 hospitals (82%) posted a machine-readable file that was compliant with the website assessment criteria, and 421 (70%) were compliant with both parts of the rule.

The findings from CMS' latest website assessment suggest that hospitals have made significant strides in their implementation efforts since the rule first went into effect on Jan. 1, 2021.

However, Seshamani and Jacobs noted that since the agency's review was limited to regulatory requirements that can be determined by external parties, the results cannot be used to gauge compliance with every regulatory requirement.

"We believe the multifaceted effort that CMS has undertaken since initially implementing the regulation—including efforts to educate, monitor, and enforce the regulations with increased applicable potential penalty amounts, along with heightened public interest and scrutiny—have driven this improvement," Seshamani and Jacobs wrote. (Seshamani/Jacobs, Health Affairs, 2/14; AHA News, 2/16)