Hospitals face loss of Medicare payments for defying price disclosure rule

Beginning Jan. 1, hospitals across the nation must disclose the rates they negotiate with Medicare Advantage plans. Some hospitals considered defying the rule, but a new penalty has them rethinking their decision, according to Bloomberg Law

The initial price transparency regulation included a fine of $300 a day for hospitals that didn’t comply with the rule. Some hospitals considered defying the rule because the cost of disclosing the rates would be more than the fine. The American Hospital Association projects it will initially cost hospitals $500,000 a year to comply with the rule, according to Bloomberg Law

However, CMS’ Inpatient Prospective Payment System final rule for 2021, released in September, included a much steeper penalty than originally proposed. The rule said hospitals that don’t comply with the price disclosure rule could be denied Medicare payments, according to the report. 

“There was certainly a sense among hospitals that one way to address the enormous amount of time and resources” required to comply with the rule was to pay the fines, Mark Polston, a partner at King and Spalding’s healthcare practice, told Bloomberg Law. “That’s now changed” with hospitals’ Medicare payments at risk. 

Read the full Bloomberg Law article here

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