| The Trump administration on Tuesday started rolling out social media messages warning hospitals that a grace period to comply with updated price transparency rules is over, and they’ve got to post their prices — or else. The Centers for Medicare and Medicaid Services has identified more than 500 hospitals as not complying with the rules since the grace period ended in April, according to newly updated federal data. The Associated Press first reported about the list of hospitals, some of which received warning letters from the agency, while others have been ordered to detail plans on how they will come into compliance. “Many of the hospitals are owned by large, well-resourced health systems, billion-dollar networks with armies of lawyers and compliance teams and lobbyists — and are still hiding their prices from the patients that they serve,” CMS Administrator Mehmet Oz said in a video posted to social media. “If those hospitals are not coming to compliance and transparently displaying their prices to patients, they will be fined to the fullest extent that the law allows,” Oz said, adding that penalties can accumulate by the day and increase to millions of dollars per year. Meanwhile, hospitals argue that many errors are merely technical and can be quickly remedied. While regulators have sent hospitals thousands of warning letters and orders to correct deficiencies since the beginning of the Trump administration, only 10 facilities have received a fine, according to a federal database. Since the rules were initially implemented in 2021, CMS reports hitting just 28 hospitals with a fine for not complying with transparency requirements. Ashley Thompson, the senior vice president for public policy analysis at the American Hospital Association, emphasized that the “majority of hospitals” are in compliance with the newly updated federal transparency rules, which took effect earlier this year. “At the same time, we also know the current system is not working as well as it could for patients, which is why we continue to work with our members, policymakers and the administration on ways to strengthen and improve the pricing information and transparency tools that are available,” Thompson said. Connecting the dots: Policymakers in both parties have latched onto codifying and improving the price transparency regulations as a way to lower health care costs. Medical care prices rose 2.6 percent over the past year, according to inflation data released Wednesday by the Labor Department. Health care costs increased 0.3 percent in May after a slight decline in April, driven largely by a 0.7 percent jump in hospital services prices. The physician services index was unchanged from the previous month. Prescription drug prices measured by the Labor Department decreased by 0.9 percent — but the data is a little more complicated than it seems and doesn’t mean the pharmaceutical industry is slashing medicine prices, as I wrote in April following the monthly Bureau of Labor Statistics data release. Meanwhile, over on Capitol Hill, the House Energy and Commerce Health subcommittee discussed a slew of bills aimed at shining more light on the health system. The key question raised at the hearing: After years of transparency requirements, why are prices still so difficult for patients and employers to find and use? Employers responsible for picking the best health plans have said they struggle to parse the massive data files submitted by hospitals and insurers. Consumer advocates have found the system unwieldy for patients despite industry efforts to update their systems. - The bipartisan slate of policy experts who testified before the panel said they favored legislation called the Patients Deserve Price Tags Act, which would codify and expand price transparency requirements for insurers, hospitals, and other health care facilities.
- Some policy experts and lawmakers have placed the blame for high health care costs on increasing consolidation throughout the industry and private equity’s increased investment in hospitals.
The panel also discussed legislation that would track hospital ownership, including requiring the disclosure of mergers and acquisitions of certain health facilities. Benedic Ippolito, a senior fellow at the right-of-center American Enterprise Institute, said that being able to have data on ownership structures would create actionable ways to lower costs. Sophia Tripoli, the senior director of health policy at the left-of-center Families USA, agreed. → “Do we have an information problem, or do we have an accountability problem?” asked Rep. Kat Cammack (R-Florida) at one point during the hearing — to which all witnesses responded “both.” “Okay, the whole system sucks,” Cammack said. “Got it.” What to watch: There’s a Senate companion to the Patients Deserve Price Tags Act in the works, so it’s worth watching whether the package could get momentum for any lame-duck package Congress may try to pass. Following the hearing, the Federation of American Hospitals, which represents for-profit hospitals, said its members have been working to give patients “consumer-friendly” pricing tools to help them make decisions. “We’ve worked with the administration on transparency efforts, sharing data and insights on factors that impact affordability,” said Charlene MacDonald, the group’s president and chief executive. “Hospitals should be judged by the care they provide and the outcomes they achieve — not by their ownership structure,” MacDonald added. “Burdensome and duplicative reporting requirements on providers do little to improve transparency or address patients’ rising out-of-pocket costs.” Read more about the price transparency policies the committee has under consideration in my preview of the hearing from earlier this week. The House Appropriations Committee voted along party lines to advance funding legislation that would cut the Department of Health and Human Services’ budget by about $4 billion — yet rejecting larger cuts requested by the Trump administration. The 34-28 vote late Tuesday evening reflects opposition among Democrats to the GOP-led proposal to slash money for addiction treatment and mental health services, Title X family planning, and HIV/AIDS prevention programs. Republicans on the committee, including Rep. Robert B. Aderholt (Alabama), argued that the bill balances fiscal responsibility with supporting federal efforts, including investments in biomedical research. “Congress must prioritize resources to the greatest needs of the nation — not to programs that, while well-intentioned, have shown limited long-term impact or sustained benefit,” said Aderholt, who leads the subcommittee with oversight of the HHS budget. KEY AMENDMENT TO WATCH The panel adopted an amendment that strips funding for the implementation of a Trump administration pilot that tests AI-driven prior authorization in traditional Medicare, signaling bipartisan opposition to the program. The temporary pilot, called the Wasteful and Inappropriate Service Reduction (WISeR) model, went into effect in January in six states. The trial, set to last for six years, relies on contracts with artificial intelligence companies to process the prior authorization requests for health services considered at high risk for fraud. → The House Appropriations Committee approved a similar bipartisan amendment to block funding for the WISeR model during last year’s funding discussions, but it ultimately fell out of the final package. What’s next: The Senate still needs to move its own HHS funding bill — and the final product still needs to be approved by both chambers — but it’s worth watching to see if the provision has staying power this time around. There are other efforts to roll back the WISeR model, including one by Democrats that I scooped last month. RESEARCH FUNDING REACTION Several groups, such as United for Cures and the American Cancer Society, applauded the bill’s $100 million increase in funding for the National Institutes of Health, for a total of $48.8 billion. Some, including Research!America and the American Association of Immunologists, said they appreciated the bump, but argued it isn’t enough to maintain America’s biocompetitiveness and are pushing for more: a total of $51.3 billion. The American Public Health Association urged the House to reject the bill, citing cuts including the $1 billion reduction in funding for the Centers for Disease Control and Prevention. The Government Accountability Office found that Medicare may be overpaying for routine hospice care because hospices are paid a flat daily rate regardless of how many visits patients receive. In a report released Tuesday, the federal government watchdog said it found major differences in service levels across providers. - Among hospices serving Medicare beneficiaries in 2024, the lowest-visit providers averaged 2.5 visits per week per patient, while the highest-visit providers averaged 5.5 visits per week. Yet both groups received the same daily payment from Medicare.
- Because of that structure, GAO estimates that, on average, Medicare effectively paid low-visit hospices about twice as much per visit as high-visit hospices.
→ The report stems from a request by Rep. Richard E. Neal (D-Massachusetts), the ranking member of the House Ways and Means Committee, in 2023. “Congress has a responsibility to ensure payments reflect the care patients actually receive and we’ve long suspected that some providers are falling short,” Neal and Rep. Linda T. Sánchez (D-California) said in a joint statement about the report. “Patients deserve a hospice benefit that puts their needs first, and taxpayers deserve confidence that every Medicare dollar is being spent wisely.” - GAO compared hospice payments with Medicare’s home health benefit, which reimburses many similar nurse, aide and social worker visits on a per-visit basis.
- The agency estimated that Medicare paid roughly $16.7 billion for routine hospice home care between 2022 and 2024, but would have paid about $9.1 billion if comparable home health payment rates had been used — a difference of $7.6 billion.
Why it matters: Hospice spending has nearly doubled over the past decade, rising from $15.5 billion in fiscal 2015 to $27.5 billion in fiscal 2024. During the same period, the number of patients on Medicare receiving hospice care also grew 32 percent, to a total of 1.82 million in 2024. The length of time patients spend in hospice care also increased. → GAO argues that the current payment model may incentivize some providers to deliver fewer visits while receiving the same reimbursement, raising quality-of-care concerns and questions about how effective the program is. Industry response: The National Alliance for Care at Home said that lawmakers should be focused on “rooting out bad actors” rather than overhauling the payment system as a whole. - The group, which represents home health, hospice, palliative and home care professionals, argued that GAO’s projected $7.6 billion in savings is partly driven by reducing payments to hospices in areas with known fraud concerns, and said the watchdog “fails to recognize the distinct differences between the home health and hospice benefit structures, regulatory requirements, and skillsets needed to deliver care.”
- Hospice’s daily payment rate is a “comprehensive benefit” that’s designed to cover a broad range of services — including medications, equipment, skilled nursing staff, bereavement support and social work offerings — and around-the-clock support, according to the group.
In its report, GAO said that it “made several adjustments to account for differences between hospice payments and estimated home health per-visit payments.” What’s next: CMS officials told the government watchdog that the agency isn’t allowed by law to tinker with the payment structure, so GAO is urging Congress to direct the Department of Health and Human Services to revise Medicare’s hospice payment system for routine home care services. What to watch: Sánchez highlighted a bill she introduced that aims to modernize the hospice payment system and provide fraud protections, arguing the GAO report underscores the need to move the legislation. - Rep. Joe Wilson (R-South Carolina) became the bill’s first Republican cosponsor Tuesday.
- The GOP-led House Ways and Means Committee, which has primary jurisdiction over these issues, didn’t respond to an inquiry about whether it’s something that the panel would support advancing.
The Children’s Hospital Association has named Melinda Roach as its senior director of policy and regulatory affairs. She comes from the Medicaid and CHIP Payment Access Commission, better known as MACPAC, and previously worked at the National Governors Association. “EPA scientists say they are being pushed to downplay potential risks of household products,” René Marsh reports at CNN. “As the U.S. looks on, European countries feel growing pressure on drug prices,” STAT’s Andrew Joseph writes. The Bipartisan Policy Center report breaking down the 2026 Social Security Trustees Report (with charts!). “Push for Labor nominee is latest threat to House GOP majority,” Politico’s Jordain Carney and Meredith Lee Hill report. This newsletter is published by WP Intelligence, The Washington Post’s subscription service for professionals that provides business, policy and thought leaders with actionable insights. WP Intelligence operates independently from The Washington Post newsroom. Learn more about WP Intelligence. | 
