Highlights
A recent executive order from the Trump administration on healthcare price transparency signals this issue remains a priority
The order requires federal agencies to issue guidance on standardizing pricing information and enforcement policies by May 26, 2025
All healthcare providers should be aware of the implications of the order and begin preparing for compliance by identifying exact prices of healthcare services and a presentable format for the information
On Feb. 25, 2025, President Donald Trump issued an executive order to “empower patients with clear, accurate, and actionable healthcare pricing information.” The order signals a return to a priority from President Trump’s first term.
A 2019 executive order from the first Trump administration required hospitals and health plans to publish “meaningful price and quality information” for public use. Hospitals were required to display pricing information for up to 300 services, and health plans were to post their negotiated rates. Both types of healthcare entities were required to make the information consumer-friendly.
The 2025 executive order picks up where the 2019 executive order left off. It directs the federal government to prioritize steps to “promote universal access to clear and accurate healthcare prices.” To realize these goals, it states federal agencies must: 1) require hospitals and health plans to disclose the actual price of items and services, 2) issue updated guidance or proposed actions to ensure pricing information is standardized and easily comparable across healthcare providers, and 3) issue guidance updating enforcement policies to ensure compliance. Federal agencies have until May 26, 2025, to take these actions.
What Does This Mean for Providers?
The language of the executive order sheds some light on what healthcare providers can expect. First, while the 2019 order was directed at hospitals and health plans, the 2025 order includes no such limitation. This signals an expansion of price transparency across all provider classes. While hospitals and health plans should be prepared for new agency guidance and enforcement around price transparency, providers of all types should pay attention to this new guidance when it issues.
Second, healthcare providers should begin analyzing pricing data to identify actual costs and present the information in a useful, consumer-friendly manner. Of note, the order explicitly prohibits healthcare providers from using price estimates. They must disclose the actual prices.
Finally, healthcare providers should be prepared for increased scrutiny, additional enforcement, and faster compliance timelines. In 2023, the Centers for Medicare & Medicaid Services (CMS) enforced violations by sending noncompliant hospitals or health plans a warning notice with instructions to correct the deficiencies within 90 days. If the hospital or health plan remained noncompliant, CMS issued a correct active plan (CAP) request with a 45-day deadline. Hospitals and health plans that still did not complete the necessary steps to come into compliance received a civil monetary penalty (CMP).
Typically, providers took 195-220 days to come into compliance. As of April 2023, CMS issued 730 warning notices and 269 CAPS and imposed CMPs on four hospitals. The CMPs range from $300 to $5,500 per day of noncompliance times the number of beds at the hospital. However, the executive order signals a push for federal agencies, including CMS, to enforce price transparency faster and more rigorously. This may include use of automation to check providers’ compliance.
Key Takeaways
All healthcare providers should be aware of the implications of this executive order and the May 26 deadline, particularly those who may be at increased risk for enforcement. Since there is some question of how healthcare providers will calculate exact prices, providers should consider using this time to sort through billing data, bundled pricing, and drug prices to identify prices. Further, providers should begin considering how the information can be presented in a useful, consumer-friendly manner. Using this time can ensure providers are prepared once federal agencies begin publishing guidance on standardization and enforcement.