Becker's Hospital Review

10 CFO / FINANCE 256 hospitals warned about violating CMS price transparency rule By Alia Paavola A s of late September, CMS had issued warnings to 256 hospitals deemed not in compliance with its price transparency rule, according to Bloomberg Law. CMS said that it began sending warning letters to hospitals not in compliance with the regulation in April. e agency told Bloomberg that it had sent about 165 warning letters by mid-July. By the end of September, it warned 100 more hospitals. Hospitals have 90 days to address the viola- tions before CMS decides whether additional compliance actions are necessary. "CMS intends to continue its monitoring and enforcement activities and will issue additional warning letters on a monthly ba- sis," a CMS spokesperson told Bloomberg. e CMS final price transparency rule, which took effect Jan. 1, aims to make hospital pricing information readily available to pa- tients to compare costs and make more in- formed healthcare decisions. To aid with this, hospitals in the U.S. are required to post both a machine-readable file with the negotiated rates for all items and services and display the prices of 300 shoppable services in a consumer-friendly format. An analysis published in July of 500 hospitals conducted by the nonprofit Patient Rights Advocate found that 94.4 percent of hospitals haven't met at least one of the requirements since the rule took effect. To boost compliance, CMS has proposed increasing the minimum fine for price trans- parency violations to up to $2 million per year. Hospitals with more than 30 beds in violation of the rule would pay $10 per day for each bed, up to $5,500 per day. Hospitals with 30 beds or fewer would continue to pay up to $300 per day. is would make the an- nual penalty at least $109,500, or as high as $2 million a year for large hospitals that fail to make prices public. n AMA releases 405 CPT code changes for 2022: 5 details By Alia Paavola T he American Medical Association released updates Sept. 7 to its Current Procedural Terminology code set for 2022. Five things to know about the changes: 1. The AMA made 405 changes in the 2022 CPT code set, in- cluding 249 new codes, 63 deletions and 93 revisions. The changes will take effect Jan. 1. 2. The AMA said 43 percent of editorial chang- es in the 2022 CPT code set are tied to new technol- ogy services described in Category III CPT codes and the expansion of the proprietary laboratory analyses code set. 3. The annual CPT code update includes a series of 15 vac- cine-specific codes to efficiently report and track immunizations and administrative services. 4. Other changes in the 2022 CPT code set respond to the fast pace of digital medicine innovations. In particular, the AMA cre- ated five CPT codes to report therapeutic remote monitoring. Those codes are 98975, 98976, 98977, 98980 and 98981. 5. The AMA said it has also created codes for principal care management. This will allow physicians to report care manage- ment services for patients with chronic conditions in an effort to improve monitoring these complex health problems. The codes are 99424, 99425, 99426 and 99427. n FEMA to cover NYC Health + Hospitals' $900M COVID-19 tab By Alia Paavola T he U.S. government has agreed to reimburse NYC Health + Hospitals for nearly $900 million in pandemic-related emergency expenses, the Daily News reported Sept. 15. NYC Health + Hospitals, which oversees New York City's 11 public hospitals, filed the request with the Federal Emergency Management Agency in Oc- tober 2020. The public hospital system sought the funding to offset costs incurred from hiring extra staff and expanding capacity to care for hospitalized COVID-19 patients. In June, FEMA agreed to cover $260 million of the bill, arguing that the remaining funds were ineligible because the public hospital system combined reg- ular hospital expenses with emergency COVID-19 costs, according to the report. Since then, several lawmakers and hospital officials have urged FEMA to reverse its decision. This week, FEMA agreed to pay the health system another $620 million, for a total of $880 million. This covers almost the entirety of the hospital's original reimbursement claim, according to the report. n

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