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Exploring the Future of Price Transparency Enforcement in Healthcare

In a recent episode of the podcast Beyond the Bottom Line, Let's Talk Healthcare Finance, Revenue Cycle and Compliance, leaders from Panacea Healthcare Solutions delved into the pressing topic of hospital price transparency. CEO Kevin Chmura and Financial Services President Govi Goyal unpacked the ramifications of President Trump's executive order signed on February 25, 2025, which aims to accelerate enforcement related to hospital pricing transparency.

During their discussion, they highlighted how this order has already stirred a substantial wave of compliance actions from the Centers for Medicare & Medicaid Services (CMS). As a result, hospitals are experiencing increased scrutiny regarding their machine-readable files (MRFs). The podcast emphasized the need for healthcare institutions to adapt swiftly, as the landscape for regulatory compliance is evolving rapidly.

The Shift in Compliance

Chmura observed, "The enforcement environment is shifting fast. Hospitals that once viewed price transparency as a mere back-office requirement are now facing real penalties for non-compliance and must ramp up their efforts to meet these new expectations." The conversation underscored how CMS is intensifying its focus, prioritizing accessibility and accuracy in online price listings, prompting hospitals to evaluate their current practices rigorously.

Notably, the episode highlighted that even seemingly minor errors—such as using the term "pricing" instead of the of specific word "price" in footers—could lead to official notices from CMS, signaling that every detail matters when it comes to compliance.

The Phased Enforcement Approach

Govi Goyal contributed a wealth of knowledge regarding compliance strategies. He emphasized the importance for hospitals to perform thorough reviews of their text files and to utilize the CMS validator for their MRFs. "We're observing a phased enforcement approach; it's vital for hospitals to be proactive instead of waiting to receive violation letters," Goyal advised.

He encouraged institutions to ensure their patient estimation systems are accurately aligned with published rates to mitigate potential compliance gaps.

Future Legislative Moves

The podcast did not just focus on immediate enforcement actions but also touched on broader implications of the executive order. Goyal speculated that as commercial payers are now mandated to update their pricing files monthly, hospitals might soon be required to adopt similar practices. Furthermore, possible legislative initiatives could extend transparency requirements beyond hospitals to include non-hospital healthcare providers and incorporate quality data into pricing disclosures.

Target Audience

This insightful episode serves as a crucial resource for compliance professionals, CFOs, revenue integrity leaders, and legal teams in healthcare who are striving to stay ahead of federal mandates regarding price transparency.

How to Listen

To listen to the entire discussion on the evolution of hospital price transparency enforcement and what your organization can do to ensure compliance, visit the Panacea Healthcare Solutions website or find the episode available on Apple Podcasts.

About Panacea Healthcare Solutions

Panacea Healthcare Solutions is at the forefront of providing innovative and compliant financial strategies, pricing solutions, and revenue integrity services to healthcare organizations across the United States. Their resources empower providers to optimize performance and remain compliant amidst ever-changing regulations.