Independent Government Agency to Audit CMS on Price Transparency Enforcement
By Consumers for Quality Care, on November 30, 2022
The Office of Inspector General (OIG) of the Department of Health & Human Services (HHS) will start auditing hospital compliance to ensure that the federal price transparency rule is being followed, according to Health Leaders Media.
In September, the OIG announced there will be an audit of the Centers for Medicare & Medicaid Services (CMS) enforcement of price transparency laws that went into effect in January 2021. The findings of the audit are expected to be released next year and will show how hospitals are complying with the price transparency rule two years after going into effect.
The OIG stated, “We will review the controls in place at CMS and statistically sample hospitals to determine whether CMS’ controls are sufficient to ensure that hospital pricing information is readily available to patients as required by federal law.”
Despite the possibility of facing more than $5,500 in fines per day for noncompliance, a lack of federal enforcement has given hospitals little reason to comply, and for hospitals that do publicly post prices, many publish this data in a format difficult for many consumers to comprehend.
“If hospitals are not in compliance with CMS’ rule for listing their charges, we will contact the hospitals to determine the reason for noncompliance and determine whether CMS identified the noncompliance and imposed consequences on the hospitals,” said the OIG on its upcoming audit.
CQC calls for increased action and oversight to ensure hospitals are sharing pricing data in a transparent, timely, accessible way that benefits consumers.