Louisiana Hospitals Violate Trump's Price Transparency Rule

Rising Enforcement of Hospital Price Transparency Rules

Hospitals across Louisiana are facing increased scrutiny for failing to comply with federal price transparency regulations. This trend has led to a series of fines issued over the past five months, reflecting a renewed focus on enforcing these rules under the Trump administration.

In May, the Centers for Medicare and Medicaid Services (CMS) imposed a $93,214 civil penalty on Community Care Hospital in New Orleans. The hospital was found to have violated the requirements by not posting machine-readable pricing files online. Additionally, it failed to include essential charge elements for shoppable services and did not provide necessary website links or file formats.

Earlier this year, Northlake Behavioral Health System in Mandeville received a fine exceeding $257,000 for similar violations. These penalties highlight a growing concern among advocates about the lack of clear, upfront pricing information for patients.

Louisiana's Lag in Compliance

Connie Partoyan, Executive Director at Better Solutions for Healthcare, emphasized that hospitals in Louisiana are falling short of the federal price transparency requirements established since 2021. She pointed out that as healthcare costs continue to rise, patients and employers deserve to know exactly what they are paying for when they visit a hospital.

Ilaria Santangelo, research director for PatientRightsAdvocate.org, noted that the penalties are long overdue. She mentioned that many individuals receive medical bills that come as a shock, with prices varying significantly even within the same hospital and across different hospitals in the same region.

According to a November 2024 compliance report from PatientRightsAdvocate.org, only 15% of Louisiana hospitals reviewed were fully compliant with the federal Hospital Price Transparency Rule, which is lower than the national average of 21.1%. Moreover, just 13% of Louisiana facilities provided enough real, dollars-and-cents prices to allow meaningful comparisons.

Challenges in Providing Transparent Pricing

Santangelo explained that most hospitals in Louisiana are offering patients estimates or complex algorithms instead of actual, accountable prices. This approach makes the pricing files difficult to compare and use effectively.

The price transparency rule, introduced through a 2019 executive order by then-President Donald Trump, mandates that hospitals publish their negotiated rates, cash prices, and de-identified minimum and maximum charges in a machine-readable format. Although the Biden administration maintained the rule, Santangelo argues that enforcement was weakened, allowing hospitals to substitute actual prices with estimates or algorithms.

Under the revised Trump-era enforcement regime, hospitals must now attest, under penalty of law, that their pricing data is accurate and complete. In 2025, the administration proposed a new rule aimed at eliminating uncalculable estimates, tightening algorithm standards, and improving access to price data.

Increased CMS Enforcement Efforts

The CMS has acknowledged a significant increase in its enforcement of hospital price transparency. According to an April 26, 2023 enforcement update, the agency expanded its comprehensive pricing reviews from roughly 30–40 to over 200 per month. As of April 2023, CMS had issued more than 730 warning notices and 269 corrective action plan requests.

Despite these efforts, Santangelo noted that only about 20 hospitals in noncompliance were ever fined over four years. She suggested that the lack of meaningful penalties may contribute to low compliance rates.

Conclusion

The recent fines and increased enforcement efforts indicate a shift towards stricter adherence to hospital price transparency rules. As the debate over healthcare costs continues, the push for clearer, more accessible pricing information remains a critical issue for patients, providers, and policymakers alike.