Beginning January 1, 2021, hospitals across the country must publicly post the prices they charge for items and services, including payer-specific negotiated rates. Despite multiple legal challenges and calls for a delay in enforcement due to COVID-19, the Department of Health and Human Services ("HHS") has remained unwavering in its commitment to move forward with the new requirements.
HHS further solidified its commitment in a Centers for Medicare & Medicaid ("CMS") Special Edition MLN Connects article distributed on Friday, December 18, 2020. The article not only includes a reminder of the upcoming effective date but also states that CMS plans to audit a sample of hospitals for compliance starting in January. These sample audits will be in addition to reviews of complaints CMS receives from the public. The announcement that it will immediately begin agency-initiated audits is a notable departure from prior guidance from CMS suggesting it would rely predominantly on complaints from individuals or entities regarding a hospital's potential noncompliance.
With the effective date only a few days away, hospitals should confirm they are ready to go live with their public lists of charges on January 1, 2021.
More information from Hall Render about the Hospital Price Transparency Requirements, including pending legal challenges, is available here and here.
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