The Patients Deserve Price Tags Act: What Health Systems Need to Know
The Patients Deserve Price Tags Act: What Health Systems Need to Know
A new chapter in pricing transparency is taking shape and this time, it’s backed by legislation.
The Patients Deserve Price Tags Act (S.2355), introduced by Senators Roger Marshall (R-KS) and John Hickenlooper (D-CO), would cement and expand the federal transparency rules currently in effect. While many providers are still working to meet current CMS requirements, the bill points to a future where transparency is more visible and more strictly enforced.
For health systems, the implications go far beyond compliance checklists. This is about exposure, accountability, and strategy.
1. What the Bill Proposes
The Patients Deserve Price Tags Act (S.2355) marks a significant evolution in the price transparency landscape. While current CMS rules have laid the groundwork, this bipartisan bill would codify those standards into federal law and expand the scope of disclosure, clarifying requirements, and tightening enforcement. For health systems, that means moving beyond reactive compliance toward strategic, data-driven readiness.
The legislation would:
- Codify and strengthen CMS transparency rules that were initially implemented through executive action.
- Require all providers, including hospitals, ambulatory surgical centers, imaging facilities, and labs, to publish actual dollar amounts for standard charges, not estimates.
- Require all providers, including hospitals, ambulatory surgical centers, imaging facilities, and labs to publish actual dollar amounts for standard charges, not estimates.
- Mandate disclosure of negotiated rates, cash prices, and bundled or itemized billing for all commercial plans.
- Prohibit gag clauses that prevent the sharing of pricing data, and ensure employers, health plans, and TPAs can access claims and cost details.
This is creating a formal, bipartisan push to transform rate transparency from policy to enforceable law.
2. Why It Matters for Health Systems
The Patients Deserve Price Tags Act (S.2355) signals a turning point in federal price transparency enforcement. What was once a lightly enforced rule is on track to become a binding law with sharper penalties, fewer loopholes, and broader visibility. For health systems, this means price transparency is no longer just a compliance task, but something bigger. It’s now becoming a public-facing measure of accountability, a benchmark in payer negotiations, and a strategic differentiator in a shifting market.
The days of soft enforcement and flexible timelines may be ending.
- Legislative codification means that pricing transparency would be moved from an administrative rule to federal law, with stronger mechanisms for enforcement.
- A rule can be adjusted or deprioritized. A law becomes a codified obligation with sharper penalties, greater visibility, and fewer loopholes.
- Greater public scrutiny is inevitable. Pricing information will be more accessible not just to CMS, but with patients, employer coalitions, competitors, and journalists.
- Market expectations are shifting. Employers and health plans increasingly expect access to clear, contract-level pricing insights when negotiating or evaluating provider networks.
In short, price transparency is evolving from a compliance task to a visibility issue.
3. The Transparency Gap: Most Systems Aren’t Ready
The Patients Deserve Price Tags Act (S.2355) would significantly raise the bar for price transparency compliance, but most health systems are still struggling to meet existing CMS requirements. For example, incomplete machine-readable files (MRFs) to missing negotiated rates and placeholder values, the current state of transparency leaves health systems vulnerable to regulatory risk, reputational harm, and lost leverage at the negotiating table. If codified into law, the bill will eliminate much of the remaining flexibility.
Despite current rules in place, compliance remains low. Even with CMS transparency rules already in effect, a majority of hospitals are still falling short and the gap is wider than many realize.
- A recent audit found that only 21% of hospitals are fully compliant with existing CMS price transparency requirements.
- Many machine-readable files (MRFs) are incomplete, improperly formatted, or missing negotiated payer rates.
- Placeholder values and hard-to-parse formats limit the usefulness of posted data, both for patients and payers.
This creates many risks and under new legislation, the margin for error will shrink.
4. What Health Systems Should Be Thinking About
Health systems that approach transparency as a forward-looking capability, not just a requirement, will be better prepared for what comes next. Treating price transparency purely as a regulatory burden leads to minimal effort, slow updates, and missed opportunities. But when health systems invest in transparency as a strategic asset, they unlock multiple forms of value:
Key priorities include:
- Validating pricing disclosures to ensure accuracy, completeness, and machine readability.
- Expanding internal visibility into how posted rates compare to the market.
- Proactively identifying risk areas including missing files, outdated formats, or low-rate service lines that could weaken contract negotiations.
- Aligning pricing, compliance, and strategy teams around a shared understanding of transparency trends and regulatory shifts.
This isn’t about doing the bare minimum but more about staying ahead of policy, market, and payer expectations.
Stay Ahead with Trek Health
Price transparency is no longer a niche policy issue, it’s reshaping how care is priced, paid for, and negotiated.
At Trek Health, we follow every legislative update, CMS shift, and enforcement trend shaping this space so health systems can stay informed, proactive, and prepared.
Subscribe to our Weekly Pulse newsletter for clear, strategic updates on all things price transparency.
Bookmark us as your go-to source for analysis, regulation breakdowns, and what these changes mean for your system.
We’ll keep watching the legislation, enforcement, and market signals so you don’t have to.
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The Patients Deserve Price Tags Act: What Health Systems Need to Know
A new chapter in pricing transparency is taking shape and this time, it’s backed by legislation.
The Patients Deserve Price Tags Act (S.2355), introduced by Senators Roger Marshall (R-KS) and John Hickenlooper (D-CO), would cement and expand the federal transparency rules currently in effect. While many providers are still working to meet current CMS requirements, the bill points to a future where transparency is more visible and more strictly enforced.
For health systems, the implications go far beyond compliance checklists. This is about exposure, accountability, and strategy.
1. What the Bill Proposes
The Patients Deserve Price Tags Act (S.2355) marks a significant evolution in the price transparency landscape. While current CMS rules have laid the groundwork, this bipartisan bill would codify those standards into federal law and expand the scope of disclosure, clarifying requirements, and tightening enforcement. For health systems, that means moving beyond reactive compliance toward strategic, data-driven readiness.
The legislation would:
- Codify and strengthen CMS transparency rules that were initially implemented through executive action.
- Require all providers, including hospitals, ambulatory surgical centers, imaging facilities, and labs, to publish actual dollar amounts for standard charges, not estimates.
- Require all providers, including hospitals, ambulatory surgical centers, imaging facilities, and labs to publish actual dollar amounts for standard charges, not estimates.
- Mandate disclosure of negotiated rates, cash prices, and bundled or itemized billing for all commercial plans.
- Prohibit gag clauses that prevent the sharing of pricing data, and ensure employers, health plans, and TPAs can access claims and cost details.
This is creating a formal, bipartisan push to transform rate transparency from policy to enforceable law.
2. Why It Matters for Health Systems
The Patients Deserve Price Tags Act (S.2355) signals a turning point in federal price transparency enforcement. What was once a lightly enforced rule is on track to become a binding law with sharper penalties, fewer loopholes, and broader visibility. For health systems, this means price transparency is no longer just a compliance task, but something bigger. It’s now becoming a public-facing measure of accountability, a benchmark in payer negotiations, and a strategic differentiator in a shifting market.
The days of soft enforcement and flexible timelines may be ending.
- Legislative codification means that pricing transparency would be moved from an administrative rule to federal law, with stronger mechanisms for enforcement.
- A rule can be adjusted or deprioritized. A law becomes a codified obligation with sharper penalties, greater visibility, and fewer loopholes.
- Greater public scrutiny is inevitable. Pricing information will be more accessible not just to CMS, but with patients, employer coalitions, competitors, and journalists.
- Market expectations are shifting. Employers and health plans increasingly expect access to clear, contract-level pricing insights when negotiating or evaluating provider networks.
In short, price transparency is evolving from a compliance task to a visibility issue.
3. The Transparency Gap: Most Systems Aren’t Ready
The Patients Deserve Price Tags Act (S.2355) would significantly raise the bar for price transparency compliance, but most health systems are still struggling to meet existing CMS requirements. For example, incomplete machine-readable files (MRFs) to missing negotiated rates and placeholder values, the current state of transparency leaves health systems vulnerable to regulatory risk, reputational harm, and lost leverage at the negotiating table. If codified into law, the bill will eliminate much of the remaining flexibility.
Despite current rules in place, compliance remains low. Even with CMS transparency rules already in effect, a majority of hospitals are still falling short and the gap is wider than many realize.
- A recent audit found that only 21% of hospitals are fully compliant with existing CMS price transparency requirements.
- Many machine-readable files (MRFs) are incomplete, improperly formatted, or missing negotiated payer rates.
- Placeholder values and hard-to-parse formats limit the usefulness of posted data, both for patients and payers.
This creates many risks and under new legislation, the margin for error will shrink.
4. What Health Systems Should Be Thinking About
Health systems that approach transparency as a forward-looking capability, not just a requirement, will be better prepared for what comes next. Treating price transparency purely as a regulatory burden leads to minimal effort, slow updates, and missed opportunities. But when health systems invest in transparency as a strategic asset, they unlock multiple forms of value:
Key priorities include:
- Validating pricing disclosures to ensure accuracy, completeness, and machine readability.
- Expanding internal visibility into how posted rates compare to the market.
- Proactively identifying risk areas including missing files, outdated formats, or low-rate service lines that could weaken contract negotiations.
- Aligning pricing, compliance, and strategy teams around a shared understanding of transparency trends and regulatory shifts.
This isn’t about doing the bare minimum but more about staying ahead of policy, market, and payer expectations.
Stay Ahead with Trek Health
Price transparency is no longer a niche policy issue, it’s reshaping how care is priced, paid for, and negotiated.
At Trek Health, we follow every legislative update, CMS shift, and enforcement trend shaping this space so health systems can stay informed, proactive, and prepared.
Subscribe to our Weekly Pulse newsletter for clear, strategic updates on all things price transparency.
Bookmark us as your go-to source for analysis, regulation breakdowns, and what these changes mean for your system.
We’ll keep watching the legislation, enforcement, and market signals so you don’t have to.
