| The Office of Inspector General (OIG) recently issued a report regarding compliance with the CMS Hospital Price Transparency Rule (HPT rule). Compliance with the HPT requirements was added to the OIG’s Work Plan in 2022 due in part, to concerns raised by congressional and consumer advocacy groups as well as media reports of hospitals failure to comply with the HPT rules.
FINDINGS:
Out of the 100 hospitals audited, 37 did not comply with one or more of the HPT rule requirements including:
- Providing files in a consumer friendly format
- Including 300 shoppable services
- Providing descriptions of services
- Providing gross charges for services
- Providing discounted cash prices
- Providing negotiated rates by payer and plan
- Updating files annually
The HPT requirements are extensive. We recommend conducting audits of your hospital’s compliance with the HPT rule. Particular attention should be given to identified areas of non-compliance outlined in CMS and OIG audit reports.
The HPT requirements along with FAQs are published on the CMS website.
The OIG Report can be found here: https://oig.hhs.gov/reports/all/2024/not-all-selected-hospitals-complied-with-the-hospital-price-transparency-rule/
The CMS HPT page can be accessed here: https://www.cms.gov/priorities/key-initiatives/hospital-price-transparency
The CMS FAQ documents can be accessed here: https://www.cms.gov/priorities/key-initiatives/hospital-price-transparency/resources |
