Compliance & Legal
The IRS requires hospitals to spend on community benefit but doesn't specify what type, for what purpose or how much.
The total yearly penalty ranges from $109,500 to more than $2 million per hospital.
Failing to follow through on price transparency requirements could alienate a large swath of a given health system's customer base.
The team believes it has found the best way forward, in part through use of artificial intelligence in the EHR.
CMS' proposal would also create a new special enrollment period opportunity for low-income consumers.
The final rule is an implementation of the No Surprises Act, which was passed by Congress last year.
OIG said CMS should make changes to require accreditation organizations to perform surveys after it issues new participation requirements.
Insurers say they are out millions in payments promised under the Affordable Care Act.
The settlement is the “first and largest in the country secured by a state attorney general against a pharmacy benefit manager,” Ohio AG says.
The cost to disclose negotiated rates could be greater than the $300 a day fines, the JAMA study says.