Hospital Price Transparency: New CMS Enforcement Measures, Increased Penalties, and Ensuring Compliance

CMS' hospital transparency rule went into effect in 2021, but many hospitals disregarded the rule. Recently, CMS announced it has tightened enforcement of the rule. Under the new enforcement measures, CMS will require hospitals that violate the transparency rule to comply with all terms of a corrective action plan (CAP) within 90 days of CMS' request. Hospitals still must submit a CAP within 45 days from when CMS requests it.

Hospitals that fail to comply with the transparency requirements will face civil monetary penalties (CMPs) and publication of these penalties on the CMS website. Under the new enforcement measure, CMS will now impose automatic CMPs on hospitals that fail to comply with the CAP deadlines. If a hospital meets one but not both CAP deadlines, CMS will review the hospital's files to determine if there are violations. Those violations would be subject to an automatic CMP. Healthcare counsel should consider the legal and other risks as they work with hospitals to comply with the transparency rule.

Stephanie M. Hoffmann, Partner at Bradley Arant Boult Cummings; Alexandra B. Shalom, Attorney at Foley & Lardner and Christine Burke Worthen, Partner at Nelson Mullins Riley & Scarborough, will guide healthcare counsel on the hospital price transparency rule and CMS' new enforcement measures. The panel will examine the rule, its requirements, and the implications of the enhanced enforcement. The panel will also discuss the rule's impact on a hospital's relationship with insurers and patients and offer best practices for compliance.

The panel will review these and other essential questions:

• What do the new enforcement measures mean for hospitals?
• What impact does the rule have on other legal obligations?
• What best practices should hospitals employ to ensure compliance with the price transparency rule?

Other Speakers: 

Alexandra B. Shalom, Attorney; Foley & Lardner
Christine Burke Worthen, Partner; Nelson Mullins Riley & Scarborough

For more information, view the event details.