CMS has been highly focused on hospital price transparency compliance enforcement in 2022. Texas Department of State Health Services Chief Counsel Karen Ray reports the newly proposed Texas Hospital Price Transparency and Reporting draft regulations were officially released. The proposed rule is focused on Hospital Price Transparency Reporting and Enforcement under Operational Requirements.
The proposed rule requires the hospital’s compliance in providing Texas HHSC with hospital price transparency disclosures and reporting. In addition, the hospital must list and maintain any changes to shoppable services or standard charges. Moreover, these lists or links to the lists would be required to be publicly displayed with clear visibility on the hospital’s website home pages.
The new code gives Texas HHSC the authority to determine, implement, and prosecute licensed hospitals that do not abide by the standards developed for their creation, preservation, and practical application.
This new section allows Texas HHSC to establish rules guiding the operations and services of health and human services agencies. Licensed hospitals in this chapter that fail to comply with these regulations will face administrative penalties for their violations, enforced by Texas HHSC.
Several factors will be accounted for when determining these penalties, including:
- Past violations by the operator of the hospital
- Violation severity
- The good faith of the hospital's operator
- Alternative relevant matters that may qualify for rectifying
Calculations for these administrative penalties will also be determined by the hospital's gross revenue in the year before a penalty was imposed, for example:
- Gross revenue is under $10,000,000 = $10 per day in violation
- Gross revenue is $10,000,000 or more, but under $100,000,000 = $100 per day in violation
- Gross revenue over $100,000,000 = $1,000 per day in violation
For the complete list refer to the Example Table for Administrative Penalties.
Separate violations will be given for each day they are not corrected. In addition, violations which are not corrected and continue may be subject to a cumulative administrative penalty (amounts not subject to per day penalty cap).
The soonest possible date of adoption is projected for January 1, 2023. For more information, please see the Proposed Rules Title 25 or contact the Healthcare Regulation Rules provider via phone: (512) 834-4591.
If you need clarification on whether your hospital complies with the federal and state-level hospital price transparency requirements listed above, contact ClaraPrice today for a complimentary assessment.