Hospitals that comply with federal price transparency rules could still violate consumer protection law if the information they provide leaves patients with a misleading understanding of their costs, the Federal Trade Commission warned.
FTC Chairman Andrew Ferguson sent letters Oct. 5 to 24 of the nation’s largest health care services companies, urging them to review their pricing practices and swiftly address shortcomings. The warning focuses particularly on routine, nonemergency care scheduled in advance, when patients have an opportunity to compare providers before committing to treatment.
The letters emphasize that Centers for Medicare & Medicaid Services price transparency requirements establish a baseline for disclosure. Meeting those requirements does not necessarily satisfy a provider’s separate obligations under Section 5 of the FTC Act, which prohibits unfair or deceptive practices.
The FTC’s concern extends beyond whether a hospital makes pricing information available. Disclosures must also convey an accurate and complete picture of the expected cost. A disclosed price could be deceptive if it leaves out physician fees, facility fees or costs associated with part of the expected course of care. Patients may reasonably interpret the amount they receive as the total price, according to the agency.
The letter explains that patients often invest substantial time and effort traveling to appointments, making advance cost information particularly important. Prices for the same services can vary dramatically among facilities.
The FTC also said inadequate disclosures may qualify as unfair practices when they cause substantial harm that patients cannot reasonably avoid and that is not outweighed by benefits to consumers or competition. Without complete information sufficiently ahead of scheduled care, patients cannot compare competing providers or make informed decisions, the agency said.
The FTC argued that obscured prices also disadvantage providers that disclose costs honestly, weakening competition by preventing patients from comparing one of the central factors in choosing care.
The letters urge recipients to conduct comprehensive reviews and take corrective action where needed. They also state that the FTC will continue monitoring the health care marketplace and take enforcement action when warranted.
However, the letter explicitly says it does not reflect an individualized assessment of a recipient’s pricing practices or a conclusion that the organization violated the FTC Act.
The agency did not disclose the names of the 24 recipients.
The warning coincided with separate changes to Transparency in Coverage rules finalized by the Department of Health and Human Services, working with the Departments of Labor and the Treasury. The changes address health plan pricing data accuracy and accessibility and require personalized cost-sharing information to be available by telephone upon request, alongside existing online and paper options. The consumer tool amendments apply for plan or policy years beginning on or after Jan. 1, 2027.