Fewer Than Half of Hospitals Compliant With Federal Price Transparency Rules: Report

Fewer than half of hospitals are conforming to the federal price transparency rule that went into effect five years ago, requiring hospitals to publish all prices online, according to a September report.

The hospital compliance rate reached 49 percent in 2026, according to a Sept. 10 report from the Patient Rights Advocate organization, hitting a six-year high and up from 21 percent in the organization’s previous report in November 2024. It reviewed price data files of 2,000 hospitals, out of the more than 6,000 licensed hospitals in the United States.

The organization attributed the improvement to the Centers for Medicare and Medicaid Services’ extensive communications on technology specifications, which “have allowed hospitals to improve their compliance with price transparency file format standardization and file access requirements.”

However, only 18 percent of the 2,000 hospitals posted dollar-and-cents prices for at least half of the items and services in their files, according to the report.

“[Centers for Medicare and Medicaid Services] has made progress enforcing its hospital transparency rules, but this report shows that most hospitals still owe patients clear, usable dollars-and-cents prices they can look up before receiving care,” Cynthia Fisher, founder and chair of PatientRightsAdvocate.org, said in a statement.

“Too many patients are still being denied the real, upfront prices they need to shop for affordable care and protect themselves from overcharges,” she said.

Dollar and Cents Pricing Insufficiency

Consumers’ access to actual, usable prices is still limited, often because of the widespread use of percentages and algorithms instead of dollar-and-cents prices, the report stated.

The price transparency rule allowed hospitals to provide a percentage or algorithm when negotiated charges are unknown. But hospitals must provide “all necessary information” for the public to derive a dollar amount, according to the Centers for Medicare & Medicaid Services.

In most cases, hospitals did not provide sufficient information for the dollar-and-cents calculation, the report stated.

In July, the U.S. Senate Committee on Health, Education, Labor, and Pensions approved a bipartisan “Patients Deserve Price Tags Act” and sent it to consideration by the full Senate. The bill would require providers to publish dollar-and-cents prices for both cash and health plan negotiated prices.

In a letter to the Committee, the American Hospital Association expressed concern about “the steep financial penalties for hospital noncompliance in the discussion draft.”

The Centers for Medicare and Medicaid Services has reviewed more than 7,500 cases to make sure hospitals are following the rules. Almost none of them, or fewer than 1 out of every 10,000 cases, ended up with hospitals paying a fine, according to the hospital association.

The current enforcement process is “already resulting in hospitals correcting compliance concerns,” the association said, encouraging lawmakers to reconsider if additional monetary penalties are necessary.

Large Health System

Among the largest hospital systems, no hospitals owned by Bon Secours Mercy Health, Ochsner Health, and ScionHealth were fully compliant with price transparency rules, according to the report.

While 85 percent of HCA Healthcare hospitals were compliant with the federal rule, zero of them met Patient Rights Advocate’s dollar-and-cents pricing standard.

Also, CommonSpirit Health hospitals had a compliance rate of 73 percent, while less than a quarter (24 percent) published dollar amounts.

The health systems did not respond to The Epoch Times’ request for comments via email.

“When patients have access to real dollar-and-cents prices, they can shop as informed consumers, spot wide price variation, and be protected from overcharges,” Fisher said in a statement.

“We commend the Trump Administration and Congress for their continued efforts to make real prices available to every patient, employer, union, and taxpayer, and look forward to the day when clear, usable prices will be the standard nationwide.”