The .txt file was the requirement CMS cited most often in its 27 price transparency fines
Penalty notices citing each requirement, of the 27 notices CMS posted from June 7, 2022 to June 3, 2026. A notice counts once per requirement, for the failures CMS found at its last review before the notice
Show the numbers as a table
| Item | Penalty notices citing the requirement, of 27 | Note |
|---|---|---|
| .txt file missing from the website's root folder, or incomplete | 12 | 12 of 27 notices; cited as 180.50(d)(6)(i), 180.50(d)(6)(i)(A)-(D) |
| No consumer-friendly list of shoppable services | 11 | 11 of 27 notices; cited as 180.40(b) |
| No machine-readable file found | 9 | 9 of 27 notices; cited as 180.40(a), 180.50(a) |
| File not on the CMS template | 7 | 7 of 27 notices; cited as 180.50(c)(2) |
| Hospital name, license number and location not in the file | 7 | 7 of 27 notices; cited as 180.50(b)(2)(i)(A) |
| No "Price Transparency" link in the website footer | 7 | 7 of 27 notices; cited as 180.50(d)(6)(ii) |
| File leaves out items, charges, codes or locations | 6 | 6 of 27 notices; cited as 180.40(a), 180.50(a)(2), 180.50(b)(1), 180.50(b)(2), 180.50(b)(3), 180.50(b)(4), 180.50(b)(5), 180.50(b)(6), 180.50(b)(7) |
| File name does not follow CMS's naming rule | 6 | 6 of 27 notices; cited as 180.50(d)(5) |
| File not updated in the past year, or no update date | 6 | 6 of 27 notices; cited as 180.50(e) |
| Consumer-friendly list incomplete, out of date or not searchable | 5 | 5 of 27 notices; cited as 180.60(b)(3), 180.60(b)(4), 180.60(b)(5), 180.60(b)(6), 180.60(d)(2), 180.60(d)(3)(iv), 180.60(e) |
| Affirmation statement missing from the file | 4 | 4 of 27 notices; cited as 180.50(a)(3)(ii) |
| Charges split across more than one file | 3 | 3 of 27 notices; cited as 180.50(c) |
| Price estimator does not give the estimate the rule requires | 2 | 2 of 27 notices; cited as 180.60(a)(2)(ii) |
About the data
- Source
- CMS, Hospital Price Transparency enforcement actions (opens in a new tab)The list of civil monetary penalty notices and the notice each entry links (page last modified June 11, 2026; read October 17, 2026)
- Method
- Kent Applied read every penalty notice on CMS's enforcement actions page and coded each failure CMS cited at its last review before the notice to one of 13 requirements, by its plain-words description. Section numbers are kept as each notice cites them, because a 2024 rule renumbered parts of 45 CFR 180.50.
- Published
Free to share and embed with credit to Kent Applied (CC BY 4.0). The source data keeps its own terms.
Related charts
- From research
Since late 2024, CMS's price transparency fines cite how the file is built and found
CMS, Hospital Price Transparency enforcement actions; 45 CFR 180.50, requirements for making public hospital standard charges (eCFR) - From the blog
CMS has published 27 price transparency fines since 2022, 10 each in 2023 and 2025
CMS, Hospital Price Transparency enforcement actions; 45 CFR 180.90, civil monetary penalties (eCFR) - From research
A fine came 68 to 626 days after CMS asked the hospital for a corrective action plan
CMS, Hospital Price Transparency enforcement actions; CMS, Hospital Price Transparency Enforcement Activities and Outcomes (data.cms.gov) - From research
CMS has fined hospitals in 15 states and Puerto Rico; Texas has the most, with 5
CMS, Hospital Price Transparency enforcement actions
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