CMS has published 27 hospital price transparency fines since 2022

CMS's enforcement actions page links 27 notices, dated June 7, 2022, to June 3, 2026, in which CMS fined a hospital for breaking the hospital price transparency rule. The fines went to 26 hospitals, since one hospital received two, and they total $4,938,685. Ten came in 2023 and ten in 2025.

The rule requires each hospital it covers to make public a machine-readable file of all its standard charges and a consumer-friendly list of charges for a limited set of shoppable services. Its definitions describe a machine-readable format as a file a computer system can import or read, and a shoppable service as one a patient can schedule in advance.

How large were the fines?

Most were under $125,000: 21 of the 27 fell below that, and the median fine was $84,216. Three were above $800,000, one each in 2022, 2023 and 2024, and those three make up just over half of the total.

The rule caps the daily penalty, and the cap has changed over time. For each day in 2021, 45 CFR 180.90 capped it at $300 for every hospital, whatever its size. From January 1, 2022, the cap depends on bed count: $300 a day for a hospital with 30 or fewer beds, $10 per bed for one with 31 to 550 beds and $5,500 for a larger hospital. HHS adjusts these caps for inflation every year, and for 2025 they were $342, $11 per bed and $6,277. Each notice shows its arithmetic: the daily amount times the number of days CMS counted.

What does the chart leave out?

The chart counts fines only, and CMS sends far more warnings. Its enforcement dataset lists 3,646 warning notices and 2,107 requests for a corrective action plan, dated from April 2021 to July 2026. A corrective action plan sets out the steps a hospital will take to fix the problems CMS found and when it will finish them.

The chart also leaves out two hospitals whose entries on CMS's list are dated 2023. For each, CMS posts only a notice saying it has resolved all disputes with the hospital over the penalty, with no amount. One of those notices says CMS imposed the penalty on August 23, 2023, and CMS's enforcement dataset counts both among its 29 penalty notices.

CMS marks three of the 27 fines as under review, which under the rule means the hospital asked for a hearing, so those amounts could change. Amounts are in dollars as each notice states them, and the notices do not say what each hospital paid. The 2026 column runs through June 3, the date of the latest notice CMS has posted.

What does it mean for a hospital?

The letters that come before a fine are the ones to act on. The rule lets CMS fine a hospital that fails to answer CMS's request for a corrective action plan or fails to carry the plan out. Each of the 26 fined hospitals had been sent at least one such request before its first fine, the notices show. A fine is also public, because the rule has CMS post the penalty notice on its website.

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