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CMS New OPPS Proposed Rule Includes Monetary Penalty for Hospitals Not Complying With Price Transparency Rule

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Fierce Healthcare reports the Centers for Medicare and Medicaid Services (CMS) wants to include a per-bed monetary penalty for larger hospitals that do not comply with a price transparency rule after several analyses have shown widespread noncompliance among facilities.  It includes a provision in the proposed 2022 Outpatient Prospective Payment System proposed rule released Monday by the CMS. The regulation details payment rates for hospitals and ambulatory surgery centers (ASCs). It includes a pay hike for hospitals and ASCs but a dramatic reversal on the number of procedures that ambulatory surgery centers can perform.   The proposed rule calls for an update to OPPS payment rates for hospitals that meet quality reporting requirements by 2.3%. The agency also plans to update payment rates for ASCs by 2.3% as well.

But a major proposal in the rule is to increase penalties for hospitals not ensuring price transparency. The proposed rule keeps the $300 per day penalty, but only for hospitals that have fewer than 30 beds. Any hospital with more beds faces a $10 per bed, per day penalty up to $5,500 a day.

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