Weekly Healthcare Policy Update from Washington, DC.

CMS Begins Issuing Price Transparency Fines. This week, the Centers for Medicare & Medicaid Services (CMS) began issuing the first fines for violations of the hospital price transparency rules that took effect in January 2021, requiring hospitals to publicly display standard charge information for a number of services.

Two hospitals in one system in Georgia received letters from CMS on June 7, which listed the violations, cited previous warning letters, and set forth the fines, which total more than $1 million for the two hospitals. The letters can be found here and here.

According to recent reports, CMS has issued 352 warning letters to hospitals, and 157 hospitals are not yet in compliance. This week’s issuance of fines to the two Georgia hospitals indicates that additional compliance efforts could be forthcoming.

CMS Extends Deadline for Home- and Community-Based Services Enhancements. On June 3, CMS sent a letter to State Medicaid Directors, informing states that they now have one additional year to use funding made available by the American Rescue Plan (ARP) to enhance, expand, and strengthen home- and community-based services ( HCBS) for people with Medicaid who need long-term services and supports.

The ARP provided states with a temporary 10% increase to the federal medical assistance percentage (FMAP) for certain Medicaid expenditures for HCBS, and states originally had a three-year period—from April 1, 2021 through March 31, 2024—to use the funds on efforts to enhance, expand, or strengthen HCBS in Medicaid. The June 3 notification means that states now have until March 31, 2025 to use this increased funding.

According to a CMS press release, the extended timeframe will help to facilitate high-quality, cost-effective, person-centered services for people with Medicaid, and will allow beneficiaries to remain in the service setting of their choice. CMS will continue to monitor states during this extended time period, with respect to progress and compliance.

Funding for HCBS was a key component of the House-passed Build Back Better Act, which included new investments of $150 billion into these services. It is not yet known if negotiations on a slimmed-down reconciliation package will be productive or if any funding for HCBS services will be included if it is.

Leave a Comment

Your email address will not be published.