A large number of hospitals have yet to comply with that historic rule, which went into effect January 1 and also requires them to provide in an online, searchable way the rates for 300 common services, such as X-rays, outpatient visits, Cesarean deliveries and lab tests. In addition, hospitals must disclose the amount they are willing to accept in cash.
CMS wants to hike the fine to as much as $5,500 for hospitals with more than 30 beds, according to the proposed rule, released Monday. Smaller hospitals would still face a penalty of $300 a day.
The minimum annual penalty would be $109,500 per hospital, which is the current fine, but the maximum would increase to as much as $2 million per hospital.
Some 6,000 hospitals are subject to the price transparency rule.
CMS said it takes seriously concerns it has heard from consumers that hospitals are not making clear, accessible pricing information available online.
“With today’s proposed rule, we are simply showing hospitals through stiffer penalties: Concealing the costs of services and procedures will not be tolerated by this administration,” said HHS Secretary Xavier Becerra.
Only 5.6% of hospitals were compliant with the rule, according to a recent review by PatientRightsAdvocate.org, a consumer group that looked at a random sample of 500 hospital websites.
Health policy experts aren’t so sure, however. The theory is that patients will visit the hospital websites and choose lower-priced options, which will lead to competition in the US health care system and drive prices down. But studies show that previous transparency efforts haven’t worked.
Insurers must disclose out-of-pocket costs in 2023
A separate rule, which was made final in October and takes effect in 2023, requires insurers to provide an online shopping tool that allows consumers to see negotiated rates with providers and gives them estimates of their out-of-pocket costs for 500 common shoppable items and services.
The following year, insurers must show all remaining procedures, drugs and other items.
This measure was prompted by feedback that consumers are more interested in what they are on the hook for based on their insurance plans’ deductibles and copays.
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