Hospital Price Transparency in 2022

Updates to the Price Transparency of Hospital Standard Charges occur within the 2022 CMS Final Rule, but what does this mean for hospitals? If appropriately addressed, it could translate to an advantage.

Highlights of the change include:

• Increase in Civil Monetary Penalties (CMP):
  • Hospitals with 30 Beds or less = $300/day
  • Hospital with >30 Beds = $10/bed/day, not to exceed $5,500/day
  • Full Calendar Year Non-compliance Minimum = $109,500
  • Full Calendar Year Non-compliance Maximum = $2,007,500
• Deeming State Forensic Hospitals as Having Met Requirements:
  • CMS will not require state forensic hospitals to participate so long as they do not offer services to the general public.
• Prohibiting Additional Specific Barriers to Access to the Machine-Readable File:
  •  CMS requires that the machine-readable file be accessible to automated searches and direct downloads.

These changes mean that some facilities have just about one month to make significant changes to their publicly available data to avoid the penalties that Medicare will impose once audits commence in 2022. 

Price Transparency is not going away, but being well prepared and using the data to your advantage will put you ahead of the curve.  MedCom can help you:

• Ensure your pricing data complies with price transparency regulations
• Leverage publicly available market data and analyze for price transparency, comparison, and defensibility
• Aggregate public payor rates and assess for payor contract negotiation indicators

About MedCom Solutions

MedCom Solutions creates patented technology and state-of-the-art software to help health care providers meet rapidly escalating and changing revenue cycle demands. Our Chargemaster, Pricing, Reimbursement, and Compliance solutions have yielded hundreds of millions in net revenue for healthcare providers across the country.

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