All hospitals in the United States are now required to make a public machine-readable online file to include all four standard charges: gross charges, payer's specific negotiated charges, discounted cash charges, and de-identified minimum and maximal negotiation charges. In fact, most hospitals nationwide are not complying with these requirements but instead, the government has issued warning notices requesting action plans or else they will impose civil monetary penalties of $300 per day for hospitals with fewer than 30 beds, upward of fines of $500 a day for large hospitals that exceed 30 beds. Hospitals with 30 beds have total minimum penalties of $109,500 per hospital with a full year of noncompliance. Large hospitals, with greater than 30 beds, will have a total maximum penalty of $2,007,500 per hospital for a full year of noncompliance.
Without trying to dissect the language embedded in the proposal such as 'shoppable services', 'machine readable files' or 'limited set' services, the following article focuses on the absurdity of these CMS civil monetary penalties. The authors performed a financial analysis of three largest 'for profit' hospitals and demonstrate the absurdity of these minimalist penalties.