December 23, 2020

Around the nation: CMS to audit hospitals for compliance with transparency rules in 2021

Daily Briefing

    CMS on Friday announced that, beginning next month, it will audit a sample of hospitals to ensure that they're complying with the agency's new price transparency rules, in today's bite-sized hospital and health industry news from California and Maryland.

    • California: The Coalition of Kaiser Permanente Unions on Monday announced that Kaiser Permanente will give 85,000 health care workers a "hero bonus" in recognition of their care for patients during America's coronavirus epidemic. Kaiser is giving the bonuses to environmental services employees, nurses, respiratory therapists, and other essential staff members. The coalition also announced that Kaiser is extending Covid-19-related paid-leave benefits through March 31, 2021, for workers who are exposed to or contract the novel coronavirus, and the health system will continue to offer $200 weekly child-care grants for staff through April 3, 2021 (Bean, Becker's Hospital Review, 12/21).
    • California: Data from the California Department of Public Health shows that at least 152 children in the state have been diagnosed with a multi-system inflammatory syndrome known as MIS-C—a rare and potentially fatal condition that's believed to be associated with the coronavirus—as of Dec. 14. Experts say a recent increase in newly reported cases of MIS-C appears to be directly connected to surges in Covid-19 cases in California. Throughout the United States, CDC has identified a total of 1,288 cases of MIS-C, which have led to at least 23 deaths, from the start of America's coronavirus epidemic to Dec. 4 (Coleman, The Hill, 12/21; Shalby, Los Angeles Times, 12/21).
    • Maryland: CMS on Friday announced that, beginning next month, it will audit a sample of hospitals to ensure that they're complying with the agency's new price transparency rules, which are scheduled to take effect Jan. 1, 2021. According to CMS, hospitals under the new regulations will be required to post online "a machine-readable file … that includes all standard charges (including gross charges, discounted cash prices, payer-specific negotiated charges, and de-identified minimum and maximum negotiated charges) for all hospital items and services," as well as publicly post "discounted cash prices, payer-specific negotiated charges, and de-identified minimum and maximum negotiated charges for at least 300 'shoppable' services." CMS said it will select a sample of hospitals to audit, evaluate complaints of noncompliance that are submitted to the agency, and review analyses of noncompliance. CMS said it will send written warnings to hospitals that aren't in compliance with the new regulations. If they still do not comply, CMS will then send noncompliant hospitals a request for a corrective action plan, and if steps are not taken, it will later follow up with a fine of up to $300 per day, which will be publicized on CMS' website (Stein, Inside Health Policy, 12/18 [subscription required]; Paavola, Becker's Hospital CFO Report, 12/21).

    New: The hospital price transparency rule cheat sheet

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    The health care industry is confronting an affordability crisis. The new hospital price transparency rule is CMS’ boldest effort to improve price transparency in the health care market place. Read on to see our take on the rule's implications.

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