OIG Adds Hospital Price Transparency to Work Plan

Today, the OIG added hospital price transparency to their Work Plan.  The hospital transparency rules were effective January 1, 2021 and require hospitals to publish their charges for items and services in a specified, consumer-friendly format.  

CMS has been conducting audits of hospital compliance with the price transparency rules and have issued civil monetary penalties to hospitals found to be non-compliant.

The OIG has indicated they also intend to perform statistical samples of hospitals to determine whether hospital pricing information is in compliance with Federal Law.  They will also be evaluating CMS’s current processes to determine whether they are adequate to identify non-compliance with the price transparency requirements.  Hospitals who are found to not be in compliance will be contacted by the OIG and they should be prepared to explain their reason(s) for non-compliance.

If you have not already evaluated your compliance with the price transparency rules, we recommend doing so at this time.  

The OIG Work Plan is located at: https://oig.hhs.gov/reports-and-publications/workplan/updates.asp

CMS Price Transparency resources are located at: https://www.cms.gov/hospital-price-transparency

HBE’s team of experts is available to assist you with conducting risk assessments, routine auditing and monitoring, policy and procedure development as well as customized education and training for your clinical and administrative staff.

DISCLAIMER:  This newsletter contains only summary information and highlights; it should be read in conjunction with the full article or document provided as a link.  Any advice or recommendations are general and specific questions should be directed to professional counsel.

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