News: New executive order targets price transparency requirements for hospitals

The Trump administration recently signed an executive order directing the Department of Health and Human Services (HHS) to modify price transparency practices in the healthcare industry.

The executive order, entitled “Making America Healthy Again by Empowering Patients with Clear, Accurate, and Actionable Healthcare Pricing Information,” requires:

[H]ospitals to maintain a consumer-friendly display of pricing information for up to 300 shoppable services and a machine-readable file with negotiated rates for every single service the hospital provides; health plans to post their negotiated rates with providers as well as their out-of-network payments to providers and the actual prices they or their pharmacy benefit manager pay for prescription drugs; and health plans to maintain a consumer-facing internet tool through which individuals can access price information. 

In 2023, CMS updated its price transparency enforcement processes to require corrective action plan completion deadlines, impose civil monetary penalties earlier and automatically, and streamline the compliance process.

In the 2024 Outpatient Prospective Payment System final rule, CMS issued a multitude of new requirements with varied implementation deadlines. Over the last few years, hospitals have had to improve web page accessibility, conform to a specific template layout, encode new MRF data elements, and more.

Hospitals continue to struggle complying with price transparency requirements. In the latest edition of its semi-annual hospital price transparency report, PatientRightsAdvocate.org found that over three-quarters of hospitals were not in full compliance with federal regulations between July and November of 2024.

Editor’s note: This article was originally published in NAHRI. To read the Trump administration’s executive order, click here. To read the PatientRightsAdvocate.org price transparency report, click here.