Key Takeaways
- The FTC has warned 24 large health care services companies that failing to provide timely, accurate and complete pricing may violate Section 5 of the FTC Act.
- Compliance with CMS hospital price transparency rules is a regulatory floor, not a safe harbor from FTC liability.
- The FTC’s message reaches all providers, including ambulatory surgery centers, imaging centers and physician groups not covered by CMS rules.
- Providers should conduct a privileged review of pricing disclosures, focusing on physician and facility fees, timing, episode-of-care pricing and accuracy against billed amounts.
On Oct. 5, 2026, FTC Chairman Andrew Ferguson sent letters to 24 of the nation’s largest healthcare services companies, stating that Section 5 of the FTC Act requires providers to give patients “timely, accurate, and complete pricing for healthcare services, especially for non-emergency services that are scheduled in advance.” The letters encourage recipients to “conduct a comprehensive review” of their pricing practices and to “take corrective action swiftly,” and warn that failing to provide such pricing may be deemed an unfair or deceptive practice.
The FTC has not publicly named the recipients, and the letter itself states that it “is not intended to reflect a particularized assessment of [the recipient’s] price transparency practices, nor is it intended to reflect a conclusion as to whether [the recipient has] engaged in conduct violative of the FTC Act.” The letter indicates that the FTC is “sending similar warning letters to other healthcare-service providers,” so the FTC’s concerns are not limited to the 24 recipient health systems, hospital-based providers or providers that previously have been identified as deficient with respect to price transparency. The letters were announced at a Department of Health and Human Services event at which the Centers for Medicare and Medicaid Services (CMS) and the Departments of Labor and the Treasury also unveiled their final rule revising the Transparency in Coverage rules, which require health plans and insurers to provide more context about in-network prices, disclose more out-of-network pricing information and strengthen accountability for the accuracy of published data.
The central message of the letters is that while the FTC is supportive of broader Trump administration efforts to promote transparency and of CMS initiatives, compliance with the CMS hospital price transparency rules (CMS rules) is not enough to comply with the FTC Act. In the FTC’s words, the CMS rules are “a regulatory floor” and “do not provide a safe harbor from liability.” Healthcare services companies should review their price transparency practices for compliance with FTC and CMS requirements.
1. Why the FTC Is Acting Now
The letter identifies price transparency as an FTC enforcement priority in several other markets, including rental housing, ticketing and auto sales. Healthcare became a stated focus when Chairman Ferguson launched an FTC Healthcare Task Force on March 20, 2026. The agency is “particularly focused on protecting vulnerable populations, including rural Americans, seniors, and veterans.” Rural systems and providers serving large Medicare or veteran populations are therefore likely to draw closer FTC scrutiny.
2. The CMS Price Transparency Rules
Congress, through the Affordable Care Act, requires each hospital operating in the U.S. to make public a list of its standard charges and shoppable services.
Since Jan. 1, 2021, CMS rules have required hospitals to post (1) a machine-readable file containing all standard charges for all items and services and (2) a consumer-friendly display of standard charges for at least 300 shoppable services. CMS expanded these requirements effective Jan. 1, 2026, and began enforcing the new requirements April 1, 2026. Among other changes, hospitals must now report standardized allowed-amount data (median, 10th and 90th percentiles), attest to the completeness and accuracy of their posted data, and identify an official responsible for data accuracy.
CMS appears to be actively monitoring hospital websites and issuing compliance letters, including corrective action plan (CAP) requests, to hospitals that have not posted a machine-readable file or whose file does not conform exactly to CMS’ required template and data specifications, including the 2026 updates. Since 2023, CMS has required hospitals to submit a CAP within 45 days and to complete it within 90 days of a CMS request. It also has stated it will impose civil monetary penalties automatically when those deadlines are missed. Hospitals should test their CSV or JSON files using CMS’ online validator before posting. The validator checks format only; it does not test the accuracy or completeness of the underlying prices. CMS publishes the hospitals that received civil monetary penalties on its public enforcement page.
The FTC letter acknowledges this framework but states that “compliance with CMS requirements does not mean that a hospital has met its obligations under Section 5 of the FTC Act.”
3. Where CMS Compliance May Fall Short of the FTC Standard
The letter relies on two prongs of Section 5 of the FTC Act. Because price is a material term, failing to disclose it or disclosing a price that is inaccurate or incomplete may be considered deceptive if it is likely to mislead consumers acting reasonably under the circumstances. Missing or late pricing may also be deemed unfair if it causes or is likely to cause substantial injury that consumers cannot reasonably avoid and that is not outweighed by countervailing benefits. The FTC takes the position that this standard can be met when pricing information is reasonably available to providers in advance. In the FTC’s view, such practices prevent patients from comparing providers and undermine competition “by obscuring one of the most important dynamics of competition from consumers’ observation and comparison.”
The table below identifies areas where practices that satisfy the CMS rules may still draw FTC scrutiny. These issues are relevant to all providers.
4. Steps for Letter Recipients
Chairman Ferguson made clear when announcing the letters that he expects prompt action: “Let me be clear: these letters are a warning. Healthcare providers must disclose their prices to consumers and must do so starting today. If they do not, then the FTC will take them to court.” He added that the FTC has already opened price transparency investigations against hospitals and that the agency “will not rest until pricing transparency in healthcare is the universal norm.” Organizations that received a letter should take the following steps:
Consider the need to identify and preserve relevant information.
Counsel should consider identifying information that would be relevant to an internal investigation, including pricing disclosures, estimate tools, scheduling communications and related policies, and implementing a document preservation notice as appropriate.
Conduct a comprehensive review under privilege.
If a review is undertaken, it should ideally be led by counsel experienced in FTC investigations, antitrust and CMS price transparency compliance, structured under attorney-client privilege.
Engage carefully and prepare for scrutiny.
The letter invites questions to the Bureau of Consumer Protection’s Division of Advertising Practices and clarifies that it does not reflect an individualized evaluation of the recipient’s practices or a conclusion that the recipient has violated the FTC Act. Whether and how to engage is a strategic decision that should be coordinated through counsel. Recipients should also consider what the organization’s response will be to a potential civil investigative demand, assume the letter itself may become public, and communicate any changes to pricing practices carefully so they are not read as an admission that their prior conduct could be challenged as deceptive.
5. Steps for Other Providers
The FTC’s message is not limited to the 24 recipients; the letter encourages “all healthcare-service providers in the United States” to conduct a comprehensive review and states that the FTC “will continue to monitor the healthcare marketplace and take enforcement action as warranted.” Ambulatory surgery centers, freestanding imaging centers, physician groups and other nonhospital providers fall outside the CMS rules but remain subject to Section 5 of the FTC Act.
Confirm whether the organization received a letter, and make sure FTC correspondence is escalated.
The FTC’s letters were sent via FedEx and may have reached individuals who did not understand their significance or been routed to a general, compliance or media mailbox where they sit unaddressed. Organizations should confirm whether a letter was received and put protocols in place to send any FTC correspondence (and other government correspondence) to the legal department immediately.
Conduct a comprehensive review under privilege.
As with letter recipients, the review should be structured under attorney-client privilege.
Confirm 2026 attestations are included.
Hospitals should confirm that their attestations of data completeness and accuracy, and the designated accountable official, are included in their hospital price transparency postings. Because the 2026 data elements differ from prior years, hospitals that resolved an earlier CAP may receive a new CAP request if they have not updated their files.
6. Enforcement Outlook
The letter states that it is “not intended to reflect a particularized assessment” of any recipient’s practices, but Chairman Ferguson has said investigations are already open. He made similar statements after the FTC’s 2025 noncompete warning letters to healthcare employers, warning that companies that did not heed them were “probably going to get” civil investigative demands.
With this FTC focus, providers should review what patients are told about price before care, including when and how completely, and address any gaps promptly.
McGuireWoods continues to monitor FTC and CMS price transparency developments. For questions about the warning letters, a pending FTC inquiry or price transparency compliance, contact the authors or a member of the Healthcare Compliance, Regulatory & Policy Practice Group.