A recent PatientRightsAdvocate.org report estimates only 5.6% of hospitals in the country are in compliance with federal hospital price transparency rules that went into effect January 1, 2021. The report, which reviewed 500 hospitals nationwide, found all 12 hospitals evaluated in Arizona to be noncompliant.
The new transparency rules require hospitals to post online a standard charges list for services. This includes negotiated prices associated with all payers and plans, as well as a charges list or price estimator tool for the 300 most common shoppable services.
The report deemed hospitals “noncompliant” if one or more transparency requirements were not met. The report states:
“The majority of noncompliant failures were the result of non-posting or incomplete posting of the negotiated prices clearly associated with all of the payers and plans accepted by the hospital. The second significant failure was due to a lack of publishing the full list of discounted cash prices.”
Specifically, the report estimates 403 hospitals did not publish payer-specific negotiated charges, 258 hospitals didn’t publish negotiated rates at all, and 198 hospitals didn’t post any discounted cash prices.
For the 12 Arizona hospitals evaluated, the report states that all failed to have complete standard charges information. Nearly all were marked noncompliant on their 300 common shoppable services lists, and several were noncompliant on their discounted cash price lists.
Under the transparency rule, CMS will issue a “notice of violation” to noncompliant facilities and will require hospitals to submit a Corrective Action Plan. If a facility fails to submit or comply with its plan, it will be subject to a maximum $300 penalty per day, at no more than $109,500 per year.
A CMS spokesperson says they have not yet issued any civil monetary penalties, but they could begin to do so soon. The spokesperson says the agency began issuing warnings to noncompliant facilities in April.