The Trump administration has 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.
In 2019, President Trump signed an executive order that directed HHS to develop rules requiring hospitals to publish prices “that reflect what people actually pay for services in a way that’s clear, straightforward and accessible to all.” Federal price transparency laws have been in effect for hospitals since Jan. 1, 2021, and July 1, 2022, for payers.
President Trump has revisited price transparency multiple times in his second term. In February 2025, he signed another executive order directing HHS and the Labor and Treasury departments to “rapidly implement and enforce” the regulations he introduced in his first term. The “Great American Healthcare Plan” proposal the White House unveiled in January called for any healthcare provider or insurer that accepts Medicare or Medicaid to prominently post their pricing and fees in their places of business.
New price transparency rules took effect for hospitals 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.
The list obtained by the AP shows that Texas-based hospitals received the most warning letters with 42, followed by California (38) and Indiana (34). Every state except Alaska had at least one hospital receive a warning letter.
Houston-based University of Texas MD Anderson Cancer Center was among the hospitals that received a warning letter, according to the report. CMS informed the cancer center that it found “a minor formatting issue involving a date field,” which was quickly corrected. CMS accepted the updated documentation and there “were no concerns regarding the integrity or completeness of the data.”
St. Louis-based Ascension — one of the largest nonprofit health systems in the U.S. — had 13 hospitals across multiple states receive letters, according to the report. The system said the letters identified a “minor technical error” and that it is committed to giving patients “the information they need to make informed decisions.”
The American Hospital Association told the AP in a statement that its member hospitals support price transparency and the majority have complied with the new requirements that took effect this year. The AHA said the price transparency system is not working as well as it could for patients, however, and that hospitals will continue working with the administration to improve pricing information and transparency.
CMS has fined 28 hospitals for alleged price transparency violations since the law took effect in 2021. To date, only one hospital has been fined for violations in 2026. Ten hospitals received fines in 2025.
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