CMS’s Secret Formula for Auditing Price Transparency Files

Hospital Pricing Specialists

As you may be aware, CMS has started aggressively enforcing the law and has issued fines to hospitals that have failed to comply. Just last month, Frisbie Memorial Hospital and Kell West Regional Hospital were publicly added to CMS’s website for non-compliance.

At HPS, we have inside intelligence on CMS’s audit process of the machine-readable files. As part of this process, CMS compares Medicare volumes for 70-defined shoppable codes (e.g., DRG 470) to what hospitals have posted in their MRF. For instance, CMS verifies whether hospitals have Medicare volumes for hip/knee replacements (DRG 470) and checks to see if the negotiated rates for this DRG are included in the MRF.

I am pleased to inform you that HPS has access to the same audit database of Medicare volumes for CMS shoppable services. For a limited time, we are offering a complimentary review of your current MRF to see if it meets CMS’s initial screen. We can help you identify any gaps in your pricing data and ensure that your hospital is compliant with the CMS price transparency law.

If you would like to take advantage of this offer and receive a complimentary audit of your machine-readable file, simply contact us, and we will take it from there. Please note that all audit results will be kept confidential, and there is no obligation to purchase any of our services.

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