For those of us following the Price Transparency rule, it’s been clear that CMS was serious about this happening (See the increased in price transparency penalties) and that many healthcare organizations weren’t in compliance. Therefore, it comes as no surprise that CMS has shared two enforcement actions against Northside Hospital Atlanta for $883,180 and to Northside Hospital Cherokee for $214,320.
When you look at the notices for these organizations, it’s fair to say that CMS gave them plenty of notice and opportunity to fix the violations. In both hospital’s case, they were notified of the violation on April 19, 2021 and May 18, 2021 followed by multiple requests for the Corrective Action Plan (CAP) from the hospital. Per the notice, Northside’s response was that patients could use their price estimate line (a phone number) or sending an email to a price estimate email.
CMS found that the phone number and email was not sufficient to comply with the price transparency requirement that the prices be published publicly and in machine readable format. When called about the lack of compliance, Northside noted that they’d intentionally removed all previously posted pricing files.
Northside chose not to comply and was thus assed the $883,180 and $214,320 fine for noncompliance from September 9, 2021 to December 31, 2021. They have 60 days to pay this or can appeal.
In the past, government fines in healthcare have been done to make a point about how serious CMS is about compliance with this rule. I’ll be interested to see if $1.1 million in fines will be a big enough wake up call for healthcare organizations to comply. CMS gave Northside plenty of opportunities, so I wonder if they just fundamentally disagreed with the rule and chose not to comply. I haven’t been able to find their side of the story, but maybe it will come out in appeal (assuming they choose this route).
While I’d love to think this is a big enough warning, when you look at the amount of non-compliance that many are sharing when it comes to the price transparency rule, it’s easy to see this just being the start of the fines.
