Lawsuit filed to force CMS to release price transparency information
The Foundation for Government Accountability wants CMS to release enforcement data it did not get by FOIA request.
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The nonprofit Foundation for Government Accountability is suing the Centers for Medicare and Medicaid Services to get information on its enforcement of the price transparency rule.
The complaint, filed August 30 in federal court in Florida, aims to compel CMS to release its price transparency enforcement records as compliance to a Freedom of Information Act request made in March.
CMS has not responded to the FOIA request, FGA said in the complaint.
WHY THIS MATTERS
In March, the FGA asked CMS for information on any and all warning letters sent to hospitals by CMS, any corrective action plans requested, and any civil monetary penalties collected.
It specifically asked for information regarding communications with 10 hospitals, including Jackson Memorial Hospital in Miami, Yale New Haven Hospital in Connecticut, AdventHealth in Orlando, Mayo Clinic Hospital-Saint Mary's Campus in Minnesota, Cleveland Clinic in Ohio, Barnes-Jewish Hospital in St. Louis, Atrium Health Carolinas Medical Center in North Carolina, UAB Hospital in Birmingham, the Johns Hopkins Hospital of Baltimore and Mount Sinai Hospital in New York.
The FGA gave no reason why these hospitals were targeted.
Hospitals have expressed concern over the price transparency rule and said they see challenges around technology and resources.
THE LARGER TREND
The American Hospital Association sued over the rule's mandate to disclose their negotiated rates with payers, and lost.
CMS began enforcing the transparency rule on January 1, 2021.
CMS issued another transparency rule which became effective a year later, increasing the penalties and also requiring the machine-readable files to be accessible through automated searches and direct downloads.
However, just 14% of hospitals were fully compliant with CMS' price transparency rule, the Advisory Board said in February, citing a survey of 1,000 hospitals by Patient Rights Advocate.
The rule requires hospitals to post online, in a machine-readable format, their standard charges for all hospital items and services. They are also required to publicly post discounted cash prices, their payer-specific negotiated charges, and de-identified minimum and maximum negotiated charges for at least 300 shoppable services, according to the Advisory Board.
Twitter: @SusanJMorse
Email the writer: SMorse@himss.org
