Pricing Transparency Updates

Beginning July 1st, 2022 CMS will enforce applicable price transparency requirements. 

For those that aren’t compliant CMS may take several enforcement actions. 

Civil penalty up to $100 per day, adjusted annually under 45 CFR part 102. 

For each violation and for each individual that is affected due to this non-compliance violation. 

It is critical your organization becomes compliant with these new regulations and requirements. 

The 3 stages in which you are required to disclose pricing information:

1. Machine Readable Files 
   • In-Network Rate File 
   • Allowed Amount File
2. Internet-based price comparison tool
   • Cost-sharing responsibility for a specific item or service from a specific provider or providers, for 500 items and services
3. Internet-based price comparison tool
   • Cost-sharing responsibility for a specific item or service from a specific provider or providers, for all items and services

Phases 2 and 3 will go into effect in 2023 and 2024. 

For additional information and details on enforcement refer to 45 CFR part 150, subparts B and C. 

For information on appealing a proposed civil penalty refer to 45 CFR part 150, subpart D. 

For help becoming compliant with these regulations contact us immediately. 

Eric V. Depew, President

MC AnalyTXs, Inc. 

3535 Briarpark, Ste. 109

Houston, Texas 77042

281-920-0300 x.101

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