The 2024 OPPS Final Rule was published last week and contained significant updates and changes to the hospital price transparency rules, many of which are effective January 1, 2024. Although there is no grace period, some requirements will be phased in.
The new requirements come on the heels of the enforcement updates that were announced earlier this year in April. Many hospitals have already been issued civil monetary penalties (CMPs) for non-compliance and numerous warning letters have been sent.
CMS is finalizing the following changes to increase standardization related to the required machine readable file (MRF) and improve access for consumers. Hospitals must:
|Requirement||Effective Date for Compliance|
|Make a good faith effort to ensure the MRF data is true, accurate and complete||January 1, 2024|
|Place a “footer” at the bottom of the hospital’s homepage that links to the webpage that includes the MRF||January 1, 2024|
|Ensure that a .txt file is included in the root folder of the publicly available website chosen by the hospital for posting its MRF The .txt file must identify the URL for both the MRF and the webpage that contains the link to the MRF||January 1, 2024|
|Affirm in the MRF that to the best of its knowledge and belief, they have included all applicable standard charge information and that it is true, accurate and complete||July 1, 2024|
|Use a specified CMS template layout, data specifications and data dictionary||July 1, 2024|
CMS has also finalized the following enforcement actions:
- CMS may publicize on its website information related to:
- Its assessment of a hospital’s compliance
- Any actions taken against a hospital including status and outcomes
- Notifications sent to health system leadership
- CMS may require certification by an authorized hospital official as to the accuracy and completeness of the MRF
- Require the hospital to acknowledge receipt of a warning notice
- If the hospital is part of a larger health system, CMS may notify the health system leadership and address deficiencies across the health system
There are many additional requirements and we recommend you read the Final Rule in its’ entirety to determine an action plan to comply with the implementation deadlines.
We also recommend conducting audits of your current price transparency compliance and focus on violations CMS has identified through prior audits. The CMPs are published on their website. As phases are implemented, it will be imperative to continue auditing efforts to ensure compliance and continue to refer back to the CMS website for other published CMPs that can help guide where you should focus.
In the published Final Rule, CMS includes 2 tables (Table 151A and Table 151B) that outline the phased implementation requirements. These can be found on pages 1,462 and 1,463 here: https://public-inspection.federalregister.gov/2023-24293.pdf
The Price Transparency Fact Sheet can be found here: https://www.cms.gov/newsroom/fact-sheets/hospital-price-transparency-fact-sheet