The Hospital Price Transparency Law, codified at 45 CFR Part 180 and effective as of January 1, 2021, was implemented to provide the public with accessible hospital pricing information, aiming to eliminate hidden fees and empower consumers to make informed healthcare decisions. Under this rule, hospitals are required to disclose prices through their website in two key formats: (1) a machine-readable file containing standard charges for all items and services, and (2) a consumer-friendly display of at least 300 “shoppable” services—services that can be scheduled in advance by a healthcare consumer. These requirements apply to most U.S. hospitals, including critical access and specialty hospitals, but exclude federal facilities such as those operated by the Department of Veterans Affairs and the Indian Health Service. Despite the rule’s intentions, enforcement by CMS has historically been inconsistent, resulting in continued noncompliance across the industry.
On February 25, 2025, President Trump issued an Executive Order intended to enhance enforcement and expand the scope of hospital price transparency regulations. The Executive Order directs federal agencies to improve compliance oversight and ensure that pricing data disclosed by hospitals is clear, consistent, and actionable. The order also calls for standardization of pricing data across hospitals to facilitate comparison shopping, particularly for non-emergency or elective procedures, making it easier for patients to evaluate and compare healthcare costs. To support this effort, the Executive Order mandates more active enforcement, including public identification of hospitals that fail to meet transparency requirements.
Since President Trump took office, the Centers for Medicare & Medicaid Services (CMS) has already taken more enforcement actions than in all of 2024. However, the average penalty imposed has decreased significantly. This shift suggests a strategy of broader but less severe enforcement, aimed at encouraging widespread compliance without imposing prohibitively high penalties.
Notably, the order also signals a potential expansion of transparency obligations beyond hospitals to other healthcare stakeholders, such as health plans, potentially including the disclosure of pharmaceutical pricing. Federal agencies have been directed to propose implementing policies within 90 days, indicating a fast-tracked regulatory agenda. As these regulatory efforts move forward, hospitals and related stakeholders should be prepared for increased public scrutiny and evolving compliance expectations.
Hospitals and insurers should begin preparing for enhanced compliance oversight. Hospitals, in particular, will need to ensure the accuracy and completeness of their price disclosures and digital transparency tools. Insurers must also verify that negotiated rate information is published clearly and consistently. Ultimately, the renewed federal focus on transparency is intended to benefit patients by improving their ability to compare costs and anticipate healthcare expenses.
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