Georgia Hospitals Fined for Hospital Price Transparency Violations

Two Georgia hospitals have received fines from CMS for violating the hospital price transparency rule.

Following unanswered warning notices, CMS sent notices of imposition of a civil monetary penalty (CMP) to William Hayes, chief executive officer of Northside Hospital Cherokee in Canton, GA, and Robert Quattrocchi, president and chief executive officer of Northside Hospital Atlanta in Atlanta, GA.

The notice sent to Northside Hospital Cherokee stated that CMS completed a review of the hospital’s website in September 2021 and found the facility to be noncompliant with the hospital price transparency rule.

The agency issued a warning notice on May 18, 2021, to which the hospital did not respond. In addition, CMS issued a Request for Corrective Action Plan (CAP) in October 2021, notifying the hospital of its violations, but the facility did not submit a CAP.

As a result, CMS has fined the hospital a total of $214,320, due within 60 calendar days from June 7, 2022. The fine reflects $300 per day of noncompliance from September 9, 2021, to December 31, 2021 ($34,2000), and $10 per bed (114 beds) per day (158 days), amounting to $180,120.

CMS may issue additional fines if the hospital continues to violate the price transparency rule, the notice stated. Additionally, the hospital must notify CMS when it makes the necessary corrections to achieve compliance.

According to the notice, Northside Hospital Cherokee violated the comprehensive machine-readable file requirement. The facility did not comply with the regulation requiring each hospital location operating under a single hospital license with a different set of standard charges than other locations to publish its standard charges separately.

In addition, the hospital did not publish a machine-readable file with a list of all standard charges for items and services, nor did it publish the information in a single digital file.

The hospital also violated the shoppable services requirement, failing to publish a consumer-friendly list of standard charges for common services.

Similarly, Northside Hospital Atlanta received a warning notice in April 2021 and was unresponsive.

CMS sent a Request for Corrective Action Plan in September 2021, and the hospital sent correspondence in November 2021 that did not specify any corrective actions it intended to take, according to the notice. The hospital received a request for a revised CAP in December 2021, but the hospital did not respond.

CMS has fined Northside Hospital Atlanta $833,180 for violating the price transparency rule. The fine includes $36,300 reflecting $300 per day of noncompliance and $846,880 reflecting the $10 per bed (536 beds) per day (158 days) penalty.

The hospital must pay the fine within 60 calendar days of June 7, 2022, and may face additional penalties for continuous noncompliance.

According to the notice, Northside Hospital Atlanta violated the machine-readable file requirement, failing to publish standard charges applicable to its location and neglecting to post a machine-readable file with a list of all standard charges in a single digital file format.

Additionally, the hospital did not publish a consumer-friendly list of standard charges for shoppable services.

The Georgia hospitals may appeal the CMS penalty determinations by requesting a hearing before an Administrative Law Judge of the HHS Department of Appeals Board. The hospitals must submit a hearing request within 30 calendar days of the notice issuances.

Compliance with the hospital price transparency rule has been low since the regulation went into effect. CMS has sent warnings to noncompliant facilities, but this is the first time the agency has issued monetary penalties.