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CENTERS FOR MEDICARE & MEDICAID SERVICES (CMS)

MLN Connects - Official CMS news from the Medicare Learning Network®
Friday, February 28, 2025

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*Hospitals: Actions to Make Healthcare Prices Transparent*

*Update*: On February 25, the White House issued an Executive Order [ https://www.whitehouse.gov/presidential-actions/2025/02/making-america-healthy-again-by-empowering-patients-with-clear-accurate-and-actionable-healthcare-pricing-information/ ] to empower patients with clear, accurate, and actionable healthcare pricing information. Read the fact sheet [ https://www.whitehouse.gov/fact-sheets/2025/02/fact-sheet-president-donald-j-trump-announces-actions-to-make-healthcare-prices-transparent/ ] for more information, which indicates the Departments of the Treasury, Labor, and Health and Human Services will:


* Ensure hospitals and insurers disclose actual prices, not estimates, and take action to make prices comparable across hospitals and insurers, including prescription drug prices
* Update their enforcement policies to ensure hospitals and insurers are in compliance with requirements to make prices transparent

*Existing CMS guidance: *Hospital Price Transparency [ https://www.cms.gov/priorities/key-initiatives/hospital-price-transparency/hospitals ] regulations require each hospital operating in the U.S. to provide 1) a comprehensive machine-readable file with the standard charges for all items and services the hospital provides and 2) a display of shoppable services in a consumer-friendly format.

*Additional resources available*:


* Hospital Price Transparency Tools [ https://cmsgov.github.io/hpt-tool/ ]: CMS offers a suite of tools to aid hospitals in implementing hospital price transparency. These tools are designed to help facilitate compliance with regulations and enhance the accessibility of pricing information. The Online Validator ensures machine-readable files meet CMS template layouts and data specifications, enabling hospitals to identify and fix errors before publication. The HPT TXT Generator helps hospitals create the required cms-hpt.txt file, which contains information about the hospital and a direct link to the machine-readable file.
* Data Dictionary GitHub Repository [ https://github.com/CMSgov/hospital-price-transparency ]: Here hospitals can access the CMS templates and data dictionary with technical instructions for encoding required standard charge information and get technical support.
* For any questions related to hospital price transparency, email PriceTransparencyHospitalCharges@cms.hhs.gov.

*Compliance: *CMS is planning a more systematic monitoring and enforcement approach, per the Executive Order. Consistent with standing CMS policies, non-compliance will be addressed with swift enforcement. See a list of enforcement actions [ https://www.cms.gov/priorities/key-initiatives/hospital-price-transparency/enforcement-actions ] to date and see a list, updated quarterly, of enforcement activities and their outcomes [ https://data.cms.gov/provider-characteristics/hospitals-and-other-facilities/hospital-price-transparency-enforcement-activities-and-outcomes ] undertaken by CMS since the January 1, 2021, effective date.

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