Administration says CMS has stepped up enforcement and updated price transparency rules for hospitals and insurers

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Evidence from credible sources supports the statement as accurate. Learn more in Methodology.

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enforcement

CMS has ramped up enforcement against noncompliant hospitals and has finalized and proposed improvements to price transparency rules as described.

Source summary

President Trump asked Congress to pass the Great Healthcare Plan, a legislative package the White House says would lower prescription drug prices, reduce insurance premiums, increase price transparency, and hold insurers accountable. The plan would codify Most-Favored-Nation drug-pricing deals, expand verified over-the-counter drug availability, redirect certain insurer subsidy payments to individuals, fund a cost-sharing reduction program the White House says would save at least $36 billion (per the CBO), and require insurers and providers to post prices and performance metrics. The fact sheet cites prior executive orders and administration actions—including 16 claimed drug-pricing deals and stepped-up CMS enforcement—to justify the proposal.

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Latest fact check

Public records from CMS show increased enforcement activity (multiple civil monetary penalty notices and an enforcement dataset listing actions into 2025), CMS issued new guidance and finalized changes to hospital price-transparency requirements in the CY2026 OPPS/Other rulemaking (Nov. 2025), and CMS and the Departments of Labor and Treasury published a Dec. 19–23, 2025 proposed rule (CMS‑9882‑P / Transparency in Coverage) to revise and strengthen insurer (payer) price-transparency requirements. These sources substantiate the claim that CMS ramped up enforcement of hospital price-transparency rules, finalized improvements for hospitals, and proposed significant improvements for insurers. Verdict: True — available CMS and interagency documents directly support the administration’s increased enforcement and rule changes/proposals on hospital and insurer price transparency.

Sources

Timeline

Update · Jan 16, 2026, 12:56 AMTrue
Public records from CMS show increased enforcement activity (multiple civil monetary penalty notices and an enforcement dataset listing actions into 2025), CMS issued new guidance and finalized changes to hospital price-transparency requirements in the CY2026 OPPS/Other rulemaking (Nov. 2025), and CMS and the Departments of Labor and Treasury published a Dec. 19–23, 2025 proposed rule (CMS‑9882‑P / Transparency in Coverage) to revise and strengthen insurer (payer) price-transparency requirements. These sources substantiate the claim that CMS ramped up enforcement of hospital price-transparency rules, finalized improvements for hospitals, and proposed significant improvements for insurers. Verdict: True — available CMS and interagency documents directly support the administration’s increased enforcement and rule changes/proposals on hospital and insurer price transparency.
Update · Jan 16, 2026, 12:43 AMTrue
Evidence shows that CMS has substantially increased enforcement of hospital price transparency rules since their 2021 implementation, including 1,287 enforcement actions from 2021–2023, with 851 actions in 2023 alone and over $4 million in civil monetary penalties to 14 hospitals, and a growing list of CMP notices through 2024–2025 on CMS’s enforcement page. CMS’s November 2023 Hospital Price Transparency fact sheet documents finalized regulatory changes effective 2024 that standardize machine-readable files, require affirmation of data accuracy, improve file accessibility, and strengthen enforcement mechanisms such as earlier and automatic penalties and public posting of compliance status. On the insurer side, CMS and the Departments of Labor and Treasury issued the December 19, 2025 Transparency in Coverage proposed rule (CMS‑9882‑P), which would amend the 2020 rules to improve standardization, accuracy, and accessibility of payer price disclosures, as summarized in CMS’s own fact sheet and independent analyses. Although some of these efforts began earlier, they were further expanded through new executive direction and rulemaking in 2025. Verdict: True, because multiple government and independent sources confirm that CMS has both ramped up enforcement and made finalized and proposed rule changes to hospital and insurer price transparency, in line with the claim.
Original article · Jan 15, 2026
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