The 2024 price transparency mandates from the Centers for Medicare and Medicaid Services are in effect, with new formatting requirements that went live on July 1. Yet some hospitals are still struggling to meet the initial Jan. 1 deadline to post a .txt file containing links to their machine-readable file (MRF) in both their root folder and a footer at the bottom of their homepage.
Here, we offer tips to help hospitals that may be experiencing issues posting the .txt files to their websites.
5 Common .txt File Issues
- File missing completely: Ensure the .txt file is present in the root directory of your public website.
- Incorrect link placement: Make sure the .txt file is directly accessible at the root URL; it can also be provided as a link on your pricing page.
- Non-compliant format: Make sure the .txt file is in the format specified by CMS. You can refer to the .txt file generator or review CMS’s list of FAQs.
- Access Blocked: Verify that the .txt file is not blocked by robots.txt, CAPTCHA, or other barriers; coordinate with your website team to resolve these issues.
- Incorrect File: Ensure the required file is a .txt file, not the machine-readable file, or you may find extra data in your text.
The .txt file requirement is meant to improve automated searches for MRFs by researchers and payors to stimulate competition.
New Template Required as of July 1
Hospital machine-readable files are now required to follow a CMS-approved format — either a “tall” or “short” CSV file or JSON schema, both available here. CMS is also requiring new data elements including additional hospital header information such as name, license number and address, plus the locations and addresses of any inpatient facilities and standalone emergency departments that operate under the same license.
CMS offers tools to help hospitals name and format their MRFs and generate a .txt file.
The next deadline is Jan. 1, 2025, when hospitals will be required to include estimated allowed amount, the average amount received from a third-party payor for an item or service, drug unit and type of measurement, and any modifiers and descriptions of them and how it could change the standard charge.
In addition, hospitals are now required to certify the accuracy and completeness of the standard charges in their MRF. They’ll also have to acknowledge when they’ve received a notice about being out of compliance with the price transparency rules, with the possibility that CMS could publicize noncompliance on a public website and require the hospital to submit a corrective action plan.
Conduct a Self-Audit
It’s a good idea for hospitals to audit themselves to verify their .txt file is accessible and contains accurate information. This audit should be conducted by members of their website team but also non-IT personnel, who can help by ensuring they are not blocked from viewing the file.
Audit teams should also run their machine-readable file through the CMS validator, and hospital pricing transparency teams should develop a process to remind themselves to update their .txt file names and locations if point-of-contact personnel or file locations change.
For more assistance, check out the extensive CMS price transparency resources or contact The Craneware Group to speak with an industry expert.