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HHS’ price transparency rule: Could it come at a worse time?

| Jan 15, 2021 | Health Care Investigations |

The United States Department of Health and Human Services’ (HHS) hospital price transparency rule went into effect January 1, 2021. Lawmakers intend the rule to help better ensure Americans have clear information about the cost of hospital items and services before receiving them. Although a noble intention, the reality of applying the rule during the coronavirus pandemic is daunting for many hospital systems.

Why so daunting? For two reasons. First, many hospital systems would use the same staff who are attempting to balance the surge in COVID-19 patients and vaccine demands. Asking this staff to manage these demands while also ensuring standard charges are available for all services provided by the hospital along with a display of at least 300 “shoppable services” is not reasonable.

The AHA also states the HHS has failed to provide “sufficient compliance guidance.” This means it will be difficult for hospital systems to implement the rule because many of the provisions within the rule remain unclear. As such, the American Hospital Association (AHA) has asked HHS to “exercise enforcement discretion” when looking to enforce compliance with this new transparency rule.

Unfortunately, at this time it does not appear that the feds will provide hospital systems with much grace when it comes to implementing this rule. According to the Centers for Medicare and Medicaid Services (CMS) the feds will immediately begin investigating a random sampling of hospital systems as well as those that are accused of non-compliance through complaints filed with the CMS. A violation could result in a warning notice, required corrective action plan or a monetary penalty along with a public notice on the CMS website.

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