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Northside Hospital fined more than $1 million for failing to publish medical prices

The hospitals that were fined are Northside Atlanta and Northside Cherokee.

ATLANTA — Northside Hospital has been fined more than $1 million over a failure by two hospitals within its system to comply with federal price transparency rules.

A spokesperson for the Centers for Medicare and Medicaid Services (CMS) said Thursday that these were the first two penalties issued for noncompliance with Hospital Price Transparency regulations that were put into place at the start of 2021.

The rules require hospitals to "provide clear, accessible pricing information online about the items and services they provide," the spokesperson said.

The hospitals that were fined are Northside Atlanta and Northside Cherokee.

The CMS spokesperson said as of this month, it had issued 352 warnings to hospitals around the country that they were out of compliance and issued 157 corrective action plan requests to hospitals that had already been warned once. 

Of those, so far just two hospitals - Northside Atlanta and Northside Cherokee - have not provided a corrective action plan to the federal agency and have now been fined.

Together they were fined more than $1 million. Northside Atlanta was fined $883,180 and Northside Cherokee was fined $214,320.

According to CMS letters sent to the hospitals, Northside Atlanta was first warned in April 2021, and the federal agency requested a corrective action plan from the hospital in September 2021. Northside Cherokee was first warned in May 2021 and a corrective action plan was requested in October 2021.

Both hospitals were cited for failing to make public a list of all standard charges for all items and services and failing to display that information in a "consumer-friendly manner."

Northside Atlanta said in a November 2021 response that it directed patients to "request specific price estimate quotes" either through email or a phone line. CMS said that "such price estimation method does not comply with the regulatory requirements."

CMS then made an additional request for a corrective action plan in December 2021. The agency further alleged that in January call this year with a Northside representative discussing both hospitals, that person, "confirmed that the previous violations had not been corrected and, in fact, the hospital system had intentionally removed all previously posted pricing files." 

The hospitals could face additional fines if it remains noncompliant, the letters indicate. They will have 60 days to pay the fine. They can also submit an appeal to the U.S. Department of Health and Human Services.

“CMS expects hospitals to comply with the Hospital Price Transparency regulations that require providing clear, accessible pricing information online about the items and services they provide. This enforcement action affirms the Biden-Harris Administration’s commitment to making health care pricing information accessible to people across the country and we are committed to ensuring that consumers have the information they need to make fully informed decisions regarding their health care," CMS Deputy Administration Dr. Meena Seshamani said in a statement.


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