CMS Outpatient Proposed Rule increases transparency law noncompliance penalties

July 22, 2021

The Proposed CY 2022 Outpatient Rule released Sunday by the Centers for Medicare and Medicaid Services (CMS) significantly increases the penalty to hospitals for noncompliance with the federal price transparency law. The law, which became effective Jan. 1, 2021, requires hospitals to post negotiated payment amounts in a machine-readable format and provide consumer-friendly access to information on 300 shoppable services. The increased penalties are in response to concerns that many hospitals have not yet implemented all the requirements. In the proposed rule, CMS proposes to scale up the existing civil monetary penalty based on bed count, up to a maximum of $5,500 per day or more than $2 million per year for large hospitals. WSHA has a bulletin and other resources regarding the transparency law available online.

The proposed rule would also reverse CMS’s prior decisions to phase out the inpatient only list (IOL) and to expand the ASC-covered procedures list (CPL). WSHA and other hospital organizations strongly opposed the elimination of the IOL and the ASC CPL expansion due to patient safety concerns. A high-level summary of the proposed rule is in in our recent Fiscal Watch article.


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