Reinforcing Hospital Price Transparency Compliance

On February 25, 2025, the White House issued an  Executive Order to reinforce healthcare price transparency compliance for radiology and other specialties. The order directs the Departments of the Treasury, Labor and Health and Human Services (HHS) to implement and enforce healthcare price transparency policy. Specifically: 

  • Confirm hospitals and payers disclose actual prices rather than estimates; 
  • Issue updated guidance or proposed regulatory guidance to safeguard pricing information is standardized and easily comparable across hospitals and health plans; and  
  • Update enforcement policies, and ensure hospitals and payers are compliant with the healthcare price transparency policy.  

In November 2019, healthcare price transparency was mandated by the administration at that time, and the Centers for Medicare and Medicaid (CMS) finalized the policy, effective January 1, 2021. The White House noted progress has “stalled” over time, and the administration wants to re-start focus on the policy.    

In alignment with the Executive Order, CMS is planning a more organized monitoring and enforcement approach, and non-compliance will be met with prompt enforcement actions.  

The current requirements of the hospital transparency policy are codified in regulations at 45 CFR Part 180 and apply to facilities that meet the definition of hospital (defined at 45 CFR § 180.20) and that are not otherwise excepted (see 45 CFR § 180.30(b)). Each hospital meeting those definitions are expected to provide “clear, accessible” online pricing information in two ways to help consumers shop and compare prices across hospitals, as well as help estimate the cost of care before going to the hospital: 

  1. A comprehensive machine-readable file will all items and services; and 
  2. A display of shoppable services in a consumer-friendly format. 

CMS has developed and maintained tools to support hospitals in meeting some of the requirements for hospital price transparency, including the online validator, command-line interface (CLI) validator, MRF naming wizard, TXT file generator and data dictionary GitHub repository. For any hospital price transparency questions, email PriceTransparencyHospitalCharges@cms.hhs.gov.