Section 180.70 - Monitoring and enforcement(a)Monitoring and assessment.(1) CMS evaluates whether a hospital has complied with the requirements under §§ 180.40 , 180.50 , and 180.60 .(2) CMS may use methods to monitor and assess hospital compliance with the requirements under this part, including, but not limited to, the following, as appropriate: (i) CMS' evaluation of complaints made by individuals or entities to CMS.(ii) CMS review of individuals' or entities' analysis of noncompliance.(iii) CMS audit and comprehensive review.(iv) Requiring submission of certification by an authorized hospital official as to the accuracy and completeness of the standard charge information in the machine-readable file.(v) Requiring submission of additional documentation as may be necessary to make a determination of hospital compliance.(b)Actions to address hospital noncompliance. If CMS concludes that the hospital is noncompliant with one or more of the requirements of § 180.40 , § 180.50 , or § 180.60 , CMS may take any of the following actions, which generally, but not necessarily, will occur in the following order: (1) Provide a written warning notice to the hospital of the specific violation(s). CMS will require that a hospital submit an acknowledgement of receipt of the warning notice in the form and manner, and by the deadline, specified in the notice of violation issued by CMS to the hospital.(2) Request a corrective action plan from the hospital if its noncompliance constitutes a material violation of one or more requirements, according to § 180.80 .(3) Impose a civil monetary penalty on the hospital and publicize the penalty on a CMS website according to § 180.90 if the hospital fails to respond to CMS' request to submit a corrective action plan or comply with the requirements of a corrective action plan.(c)Actions to address noncompliance of hospitals in health systems. In the event CMS takes an action to address hospital noncompliance (as specified in paragraph (b) of this section) and the hospital is determined by CMS to be part of a health system, CMS may notify health system leadership of the action and may work with health system leadership to address similar deficiencies for hospitals across the health system.(d)Publicizing assessments, compliance actions, and outcomes. CMS may publicize on its website information related to the following:(1) CMS' assessment of a hospital's compliance.(2) Any compliance action taken against a hospital, the status of such compliance action, or the outcome of such compliance action.(3) Notifications sent to health system leadership. 84 FR 65602 , Nov. 27, 2019, as amended at 88 FR 82185 , Nov. 22, 2023 84 FR 65602 , 1/1/2021; 88 FR 82185 , 1/1/2024