CMS Hospital Price Transparency Requirements

hospital price transparency

hospital price transparencyBy: Karina Gonzalez

On November 15, 2019 Centers for Medicare and Medicaid Services (CMS) issued a final rule requiring hospitals to publicly disclose “standard charges, including payer-specific negotiated rates for items and services. Hospitals will be required to comply by January 1, 2021. The proposed rule is subject to 60 days of comment.

The final rule requires hospitals to make public in a machine-readable file online all standard charges (including gross charges, discounted cash prices, payer-specific negotiated charges) for all hospital items and services.  It requires hospitals to de-identify minimum and maximum negotiated charges for at least 300 “shoppable” services.Continue reading

DEA Audit & Administrative Proceedings: Steps to Know

pharmacy audit dea

pharmacy audit deaBy: Matt Fischer

The Drug Enforcement Administration (DEA) is responsible for the monitoring of all manufacturing and distribution of controlled substances in the country.  Pharmacies, medical providers (i.e., who either administer, prescribe or dispense), and distributors and manufacturers of controlled substances are required to register with the DEA.  The DEA’s Diversion Control Division is tasked with reviewing applications of potential registrants and monitoring existing registrants through audits and investigations.  However, the question on many registrants’ minds is what happens if violations or deficiencies are discovered?  The answer is it depends.  The consequences will vary based on the level of noncompliance.  Thus, it is essential to be familiar with the laws that apply and most importantly, have a full understanding of the administrative process in order to act quickly to minimize potential adverse action if noncompliance is found.Continue reading