In the first six months of 2026, new price transparency rules went into effect, hundreds of hospitals received warning letters about noncompliance, but only one hospital has been fined for violations.
Here is what to know about the state of hospital price transparency in the first half of 2026:
New rules take effect
New price transparency rules took effect April 1 regarding machine-readable files. The changes focus on three core areas: attestation language and executive accountability for file accuracy, new requirements for percentile allowed amount reporting and counts of allowed amounts, and National Provider Identifier reporting.
500+ hospitals receive warning notices
The Trump administration sent warning letters to 519 hospitals nationwide citing them for failing to provide transparent pricing information, the Associated Press reported June 9.
The AP exclusively received a list of hospitals that have either received warning letters or requests to submit plans to provide transparency pricing since April. A senior administration official who requested anonymity told the news outlet that President Donald Trump plans to ramp up price transparency enforcement and more hospitals are likely to receive letters for failure to comply.
Many of the 519 hospitals that received letters said the citations stemmed from minor technical or formatting errors in their data files — not a failure to disclose pricing — and that the problems were corrected within days of notification.
Only one hospital fined
To date in 2026, one hospital has been fined for alleged price transparency violations, but in a first since the federal law took effect in January 2021, the hospital was fined twice.
Crown Point, Ind.-based Pinnacle Hospital, which has fewer than 30 beds, was issued its first fine Feb. 4. The $51,615 fine covered 155 days of noncompliance with federal price transparency rules.
CMS issued a second fine of $40,356 June 3, saying Pinnacle Hospital has remained out of compliance with federal rules, stating “specifically, no consumer-friendly list of standard charges was found.” The second fine covers 118 days of noncompliance from Feb. 5 through June 3.
Twenty-eight hospitals have been fined for price transparency violations since the law took effect. The number of violations that have been handed out has varied significantly from year to year. Ten hospitals were fined in 2025 after three were fined in 2024. A high of 12 hospitals were fined in 2023. Two were fined in 2022, the first year penalties were issued.
A request for information
As part of its 2027 Hospital Outpatient Prospective Payment System and Ambulatory Surgery Center proposed rule, CMS is seeking comment on tightening machine-readable file standards. The agency issued a request for information on how hospitals report contract mechanisms such as outlier payments, stop-loss provisions, rate tiering and carve-outs. CMS is also asking whether to modify or eliminate the deemed compliance policy for internet-based price estimator tools, a sign that stricter transparency mandates may follow.
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