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FTC warns 24 large health systems of price transparency deficiencies

The FTC letters warn of deceptive pricing practices just as the Trump administration revamped healthcare price transparency requirements for payers.

Jacqueline LaPointe
By
Published: 06 Oct 2026

The Federal Trade Commission recently sent letters to two dozen large U.S. health systems reminding them about their price transparency obligations.

FTC Chairman Andrew N. Ferguson warned in letters to the 24 unnamed health systems about "deceptive" pricing practices under its namesake law. The FTC Act prohibits anticompetitive behaviors and these so-called deceptive business practices, including hiding the true costs of a service, omitting hidden fees and providing inaccurate price estimates.

Ferguson urged health systems to review their pricing practices to determine whether they are actually delivering "timely, accurate, and complete" costs for non-emergency services scheduled in advance by patients. He warned that hospitals could be deceiving patients by omitting charges such as physician or facility fees, or by providing estimates only for a portion of the expected care.

These practices mislead consumers and could cause substantial harm to patients by obstructing competition in healthcare markets, according to the letter.

"Price transparency is particularly critical in the hospital and healthcare setting because healthcare is often one of the most significant and financially burdensome costs consumers face," wrote Ferguson.

He also specifically called out vulnerable populations, including rural Americans, seniors and veterans, who face significant challenges to accessing affordable, transparent healthcare.

"Patients frequently must invest substantial time and effort to travel for in‑person visits, making it even more important that they understand costs upfront before committing to care," he stated. "Moreover, hospitals and healthcare facilities can charge dramatically different prices for the same services, leaving consumers vulnerable to wide and often unexpected cost discrepancies."

Hospital price transparency already lags

Hospitals and health systems are already required to disclose their prices under a rule from the CMS. Since 2021, this rule has mandated hospitals to provide a comprehensive, machine-readable file with pricing for all items and services, as well as a consumer-friendly version for common shoppable services.

The CMS designed the requirements to enable consumers to shop for healthcare and compare prices across providers. However, compliance has lagged, just now reaching about half of hospitals, according to an analysis from PatientRightsAdvocate.org last month. The nonprofit has tracked hospital compliance semi-annually, analyzing pricing files for about 2,000 U.S. hospitals over the years.

The CMS has addressed compliance deficiencies with its requirements, sending warning letters to over 500 hospitals this summer. Hospitals can face penalties of up to $2 million annually for failing to comply with price transparency mandates.

However, compliance with the CMS requirements does not mean hospitals have met their obligations to the FTC, Ferguson said in the letters. He said the rule is a "critical foundation" for healthcare price transparency, but is ultimately a "regulatory floor."

"In other words, the CMS rules do not provide a safe harbor from liability under the FTC Act," the letter stated.

The warning letters do not necessarily mean the health systems have violated the FTC Act, Ferguson added. However, he said the FTC is closely monitoring healthcare marketplaces and will take enforcement actions if violations are found.

Trump goes all in on healthcare price transparency

The FTC's letters come on the heels of price transparency updates for healthcare payers.

The HHS and Labor and Treasury Departments issued a final rule on Monday that updates the Transparency in Coverage rule, which specifically requires price transparency for insurers. The rule seeks to address gaps in requirements, such as banning the inclusion of ghost rates, requiring more dollar-and-cents pricing and making payers certify the accuracy of their prices.

"Americans should know what their healthcare will cost before they receive it," said HHS Secretary Robert F. Kennedy, Jr., in a statement. "President Trump directed us to bring real price transparency to healthcare, and HHS is delivering. These rules give patients clearer, more reliable information to compare costs, understand their coverage, and make informed decisions before they receive care."

The Trump administration has prioritized healthcare price transparency in both terms, including finalizing both the CMS' hospital price transparency requirements and the TiC rule during the first term.

In February 2025, President Donald J. Trump also issued an executive order reupping his commitment to healthcare price transparency and mandating stricter federal enforcement of policies.

"The American people deserve better," the President said in the executive order. "Making America healthy again will require empowering individuals with the best information possible to inform their life and healthcare choices."

"By building on the historic efforts of my first term, my Administration will make more meaningful price information available to patients to support a more competitive, innovative, affordable, and higher quality healthcare system."

Jacqueline LaPointe is an Executive Editor at Xtelligent Healthcare Media, covering revenue cycle management, healthcare payers, health policy, and health IT since 2016. 

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