Most hospitals still aren’t posting how much they charge for medical services, five years into federal transparency rules that require them to do so.
Fewer than one in five hospitals owned by the nation’s largest health systems are displaying dollar amounts for at least half of their posted items and services, according to a survey of 2,000 hospitals by price transparency group PatientRightsAdvocate.org provided to The Washington Sun.
“This is law for us to know prices,” said Cynthia Fisher, the group’s founder. “It is not hard.”
The Trump administration has demanded hospitals start complying with the transparency regulation. The rule was written by the first Trump administration and went into effect in 2021 as part of an effort to eliminate the opaque pricing schemes that leave patients ignorant of what they’ll have to pay for a visit or procedure.
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In April, the Centers for Medicare and Medicaid Services sent warning letters to more than 500 hospitals and asked some to send compliance action plans. A CMS spokesperson didn’t say whether the agency had enacted any fines yet.
“CMS will continue working to undo four years of bad policy,” the spokesperson said, referring to a regulation update under the Biden administration which gave hospitals some wider latitude. “We’ve sent a clear message to noncompliant hospitals: post your prices or pay the penalty.”
The federal government can fine hospitals as much as $2 million annually for noncompliance. The Biden administration fined about two dozen hospitals. The Trump administration has fined a handful since President Donald Trump took office again in early 2025.
CMS Administrator Mehmet Oz and Health Secretary Robert F. Kennedy Jr. followed up with a June 9 video posted to social media warning of an impending crackdown.
“If those hospitals do not come into compliance and transparently display their prices to patients, they will be fined to the fullest extent the law allows,” Oz said.
“The grace period has ended,” Kennedy said.
Hospitals are supposed to post machine-readable files with pricing information, as well as consumer-friendly lists of hundreds of services that include either dollar prices or a price-estimator tool. The disclosures cover rates negotiated with insurers as well as the hospital’s gross list prices and the discounted cash price available to patients paying without insurance.
Fisher’s group analyzes the websites of hospitals every year to evaluate how many are following the rules. About half of hospitals surveyed are technically complying with the regulation, but most of those are skirting the spirit of the law by posting percentages or algorithms. Federal rules allow hospitals to do so when prices cannot be expressed as a dollar amount.
Around one-fifth of surveyed hospitals were technically compliant in 2024, according to the group’s annual reports.
Trump issued an executive order last year calling for hospitals and insurance companies to make it easier to view and compare prices. Earlier this year, CMS updated the regulation to specify that if hospitals list algorithms instead of dollar prices, the public must still be able to derive the dollar amount.
Andrew Bremberg, who worked on the transparency issue at the White House Domestic Policy Council, said he had expected that getting hospitals to obey the rules would take time.
“My perspective has been that when you do something like this, they’re not going to comply, and what it’s going to take is a set period of steady enforcement by CMS,” said Bremberg, who is now a policy adviser to PatientRightsAdvocate.org.
He and Fisher stress that getting hospitals to post actual dollar amounts is critical so that patients can shop around and compare prices.
“I will call them out until the cows come home for us to see these prices,” Fisher said.
CORRECTION: A previous version of this article misstated the percentage of hospitals that were in compliance with the transparency rule in 2024. It also misstated the extent of Andrew Bremberg’s role at the White House Domestic Policy Council with regard to the transparency rule.
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