Hospital Pricing Transparency Laws Not Strictly Enforced by CMS

By Consumers for Quality Care, on October 23, 2024

A new report from the Government Accountability Office (GAO) shows that the Centers for Medicare & Medicaid Services (CMS) are not doing enough to enforce hospital price transparency laws, according to Healthcare Dive.

Since January 1, 2021, hospitals have been required to disclose “clear, accessible pricing information” for their products and services by posting these prices for consumers through a “consumer-friendly” display.

However, hospital pricing data is often filled with inconsistencies and inaccuracies. In March, a study conducted by Patient Rights Advocate (PRA), a health care advocacy group, found that only about one third of hospitals were fully compliant with the law. This lack of information prevents consumers from being able to make educated decisions about their health care needs.

The GAO’s report found that some hospitals placed data behind a password-protected webpage or on a webpage that would be impossible for the average consumer to track down. The report also found that standardized procedural definitions varied across different hospital systems, making it difficult for consumers to compare prices.

GAO recommended that CMS revise its compliance review processes and use more effective enforcement strategies. Despite some sanctions imposed on non-compliant hospitals, GAO found that CMS fails to check the accuracy of a hospital’s posted pricing files, leading to questions about the effectiveness of its oversight.

More work needs to be done to ensure hospitals are complying with federal standards. CQC urges elected officials to implement increased oversight measures to ensure hospitals are releasing accurate price transparency data in a timely, accessible way that benefits consumers. Patients have a right to the information they need to compare costs, and hospitals should be held accountable when they fail to provide this information.