After Months Of Warnings, CMS Hands Out Its First Fines To Hospitals Failing On Price Transparency

CMS issues first price transparency fines to 2 Georgia hospitalsSource: Fierce Healthcare, by Dave Muoio

Eighteen months after its final rule on price transparency went into effect, the Centers for Medicare and Medicaid Services issued its first penalties to a pair of Georgia hospitals that did not update their websites or reply to the agency’s warning letters.


Northside Hospital Atlanta and Northside Hospital Cherokee have been issued civil monetary penalties of roughly $880,000 and $214,000, respectively, according to letters published on CMS’ Hospital Price Transparency website. Both hospitals are part of the same health system.

The agency calculated the penalties based on the hospitals’ size and how long their websites were non-compliant (up to $300 per day). The hospitals may submit a request for a hearing to have their penalties appealed.

“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,” Director of Medicare Meena Seshamani, M.D., said in an email statement provided to Fierce Healthcare. “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 healthcare.”

Since Jan. 1, 2021, CMS has required hospitals to post a comprehensive machine-readable list of their services and prices as well as a patient-friendly tool to help shop for 300 common services.

Hospitals that are not compliant with the requirements receive warning letters from CMS requesting they submit a corrective action plan to amend their websites.


The agency began delivering those letters in April, saying at the time it was hesitant to issue civil monetary penalties due to the harm that publicly naming noncompliant hospitals could bring to those organizations.

In the warning letters, CMS said it had conducted reviews of their websites, requested corrective action plans and delivered warning notices to both hospitals last fall. CMS issued warning to the hospitals in April and May, according to the letters, which neither hospital responded to.

CMS has issued a total 352 warning letters to hospitals as of this month, according to a CMS spokesperson. Among these, 171 received case closure notices after addressing the agency’s citations while 157 remain non-compliant, the spokesperson said.

Industry-wide compliance with the federal transparency requirements has been spotty to date. Only 14.3% of hospitals were compliant with both major components of the mandate one year after it went into effect, according to a review by


A study published in JAMA earlier this week corroborated low compliance as of the six to nine months after the rule went into effect, noting that hospitals in low-concentration healthcare markets, urban hospitals and those with lower per patient-day revenue were more likely to be in compliance.

Hospitals and health systems say their adherence struggles are the result of the high cost and complexity of implementation. They’ve also pointed to the final rule’s language, which they say is vague and difficult to interpret.

“Many organizations are not investing beyond the bare minimum requirements, and they don’t plan to do more until there is further clarity around the regulations and the expectations going forward,” KLAS Research wrote in an April report polling 66 hospital revenue cycle leaders on price transparency compliance.

After a 2-Year Ban, Hugs Are Back at Disneyland

Disneyland Hugs Return: Mickey Mouse Embraces Guests After Covid Ban - The  New York Times

Source: The New York Times, by Brooks Barnes

As the smell of cinnamon rolls and suntan lotion wafted through the spring air at Disneyland on Monday morning, Rory Sutherland flung herself on the sidewalk and had what can only be described as a hissy fit.

She was ready for a hug from Mickey Mouse — in fact, beyond ready: For more than two years, ever since the pandemic began, Disneyland’s furry inhabitants have been off limits. The park was closed for 14 months. When it reopened last April with extensive health-related modifications, Mickey and Minnie and their cohorts were kept at a distance from guests. No hugs. No autographs. No secrets whispered in little ears. Only waving from afar, which bummed out some families so much that they canceled or postponed their trips.

But on Monday, Rory, 2, trained her eyes on someone coming around the corner in red trousers and big, white gloves. Squeal-screaming, she picked herself up off the pavement and ran toward him with arms outstretched. Her mother, father and uncle chased after her and scrambled to unlock their iPhones to catch a photo of their embrace.

That’s right: Hugs are back.

“Cheese! Cheese!” Rory shouted toward her paparazzi, as Mickey knelt and started to rub noses with her. Rory’s mother, Alyssa Sutherland, wiped away a tear. “We’ve been waiting and waiting for the character interactions to come back,” Mrs. Sutherland said, noting that the family had traveled to Southern California from Lethbridge, Canada.


Mickey was himself undoubtedly in need of a hug. In addition to the lingering effects of the pandemic, Disney has been roiled over the past month by the culture wars. Employees revolted over the company’s initial silence on an anti-L.G.B.T.Q. law, and right-wing protests broke out after the company did speak up. In this hyperpartisan moment, both sides of the political divide have been pulling on Disney, leading to some not-so-magical moments around a brand that is supposed to symbolize happily ever after.

“Hugs for everyone!” one Disney employee shouted when Mickey arrived.

Some people find Disney’s extra-syrupy, tightly managed theme parks to be, well, extra-creepy. The character hugging, which has been part of the Disneyland experience since its earliest days in the 1950s, may seem particularly odd. Grown men waiting in line for the chance to squeeze a life-size Donald Duck? (Yes, adults are eligible, with or without children.)

A few videos of inappropriate behavior — by guests — have gone viral, as with a moment from 2015, when a young woman groped the muscled chest of a performer playing Gaston from “Beauty and the Beast.” (He sent her away. “You’re done,” he said, shaking his head. “There’s children.”)

In some instances, coming face-to-face with Cinderella or Winnie the Pooh or Aladdin is sensory overload. “I loved Mickey Mouse, but when I met the actual real-life Mickey, or rather, his impersonator, and he tried to hug me in his warm, fuzzy suit, I recoiled in fear,” the actress-producer Mindy Kaling wrote in her 2011 memoir.


But a lot of American families consider it a rite of childhood to hug one of Disney’s cartoon characters. Disney theme parks around the world attracted an estimated 151 million visitors in 2019, according to the Themed Entertainment Association, which has not yet released figures for 2021.

“It’s part of what makes Disney so special,” said Bri Petrarca, who had brought her sons, Grayson, 5, and Asher, 2, to meet characters on Monday. She was wearing a pink T-shirt emblazoned with the words, “Here for the hugs.”

About 50 people were waiting at that moment to hug Minnie Mouse, who had appeared in her polka dots near the Main Street U.S.A. magic shop. Three women in their 20s, each wearing mouse-ear headbands, waited their turn; one of them, Natalie Parks, from Salt Lake City, said hugging Minnie was “a chance to reconnect with my childhood.”

TikTok, Instagram and the ubiquity of camera phones have made such interactions more sought out than ever, according to Robyn Vossen, Disneyland’s general manager of entertainment operations. In some instances, characters appear without notice (always with a handler to run interference). Some characters, including the Disney princesses, are so mobbed that the company has built indoor, heavily themed environments for them to inhabit. Walt Disney World in Florida even offers front-of-the-line reservations.

“Fur characters” (those in full-body suits) do not speak and appear only for about 30 minutes at a time, largely because it can be exhausting for the performer, especially in summer heat. “Face characters,” like the princesses, do not wear masks so they can chat with guests. Disneyland has roughly 50 costumed characters in rotation, Ms. Vossen said.

With the return of character hugs, operations have been almost fully restored at Disney’s domestic resorts after a lengthy period in which social distancing and other coronavirus safety measures took priority. The company dropped most face-covering requirements in February. Disneyland’s Main Street Electrical Parade is set to return on Friday.


Disney needs this summer to be a blockbuster: The division of the company that includes theme parks had $16.6 billion in revenue last year, down from $26 billion in 2019, according to financial filings.

“Character interactions are such a big deal because they provide an emotional touch point,” Ms. Vossen said. “That personal, one-on-one interaction may be the most powerful offering that the Walt Disney Company has.”

With that, Mickey Mouse headed “offstage,” as Disney refers to its behind-the-scenes areas. “Time for a bathroom break,” one employee said.

Ms. Vossen, who has worked at Disneyland for 42 years, frowned and offered a correction. “Or to grab a quick piece of cheese,” she said.

Last Updated 06/29/2022

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