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News | Price Transparency

Healthcare News of Note: Noncompliance with new price transparency rules appears to be common

News | Price Transparency

Healthcare News of Note: Noncompliance with new price transparency rules appears to be common

  • CMS is auditing a sample of hospitals to determine whether those facilities are in compliance with the price transparency regulations that went into effect Jan. 1.
  • Tennessee's waiver to create a Medicaid block grant program in the state was approved by CMS on Jan. 8.
  • HFMA's "Voices in Healthcare Finance" podcast has undergone a makeover, and will include more  staff co-hosts, trending news updates and general interest topics like how remote workers can keep their information secure.

Among the healthcare finance news that I found interesting this past week are the following stories.

1. Early findings suggest noncompliance with price transparency is common

A Jan. 11 Healthcare Dive article reported that CMS is currently auditing a sample of hospitals to determine whether those facilities are in compliance with the price transparency regulations that went into effect Jan. 1.

“A landmark shift occurred in the nation's healthcare system at the start of the year: hospitals across the country are required to post online the negotiated rates they reach with insurers for services,” says the article, "CMS audits small slice of hospitals for price transparency, probes complaints," by reporter Samantha Liss. “Those figures previously were largely kept out of view from consumers.”

The article went on to say:

  •  After spot-checking was conducted on hospital websites, it appears noncompliance with the new price transparency policy is common.
  •  Some researchers expressed frustration over the lack of compliance and that there is no single repository for the information, requiring them to search thousands of hospital websites to find it. 
  • One researcher said making the information available to the public is important but that it’s not of much use to consumers in its current form.

Price transparency resources

CMS.gov provided information Dec. 18 on its plans for “Monitoring for Hospital Price Transparency,” with links to the following resources:

  • FAQs
  •  8 steps to a machine-readable file
  • 10 steps to a consumer-friendly display
  • Quick-reference checklist

2. Tennessee Medicaid block-grant waiver gets CMS approval

CMS “announced it had approved Tennessee's waiver to create a Medicaid block grant program in the state,” says Healthcare Dive editor Shannon Muchmore’s Jan. 8 article, “Tennessee approved for first Medicaid block grant program.”

The article went on to say, “The program, called TennCare III, uses a modified block grant that increases funding if Medicaid enrollment goes up and decreases if enrollment drops. It also allows the state to create a formulary of covered prescriptions drugs without federal approval and gives it the authority to negotiate directly with drugmakers.”

“Tennessee's request is approved for 10 years,” the article continues. “The incoming Biden administration could attempt to roll back the program, but the state would be able to challenge such a move.”

3. HFMA revamps its "Voice in Healthcare Finance" podcast

If you haven’t listened to HFMA’s "Voices in Healthcare Finance" podcast before, now is a great time to start as the podcast has undergone a makeover.

"I’m thrilled to share the first episode in our new format with new and regular listeners," said Erika Grotto, HFMA senior editor and podcast host. "In this episode, we’re tackling the challenges faced by working moms during the pandemic, as women leave the workplace in droves and risk losing years of progress. I speak with two working moms [both from McKinsey & Company] who discuss what individuals and their employers can do to make life better for working moms, and where today’s trends could lead."

With the new format, you can expect:

  • More personality. HFMA staff will regularly join Grotto as cohosts.
  • More HFMA news. We’ll talk more about Association initiatives and stories we’re working on and what those mean to member.
  • More human stories. The latest episode is a big departure from the usual “how to improve your financial performance” interviews we’ve had in the past, said Grotto. “We’re not doing away with that content on the podcast, but our members are so much more than their job tasks.”
  • More reasons to stay tuned. Topics for the next two episodes: How remote workers can keep information secure and how to maintain good mental health at a time when we’re facing challenges we never would have anticipated. 

About the Author

Deborah Filipek

is a senior editor with HFMA in Westchester, Illinois.

Sign up for a free guest account and get access to five free articles every month.

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