Dozens of Louisiana hospitals in violation of Trump price transparency order

Published 1:11 pm Wednesday, July 30, 2025

By Nolan McKendry | The Center Square

Louisiana hospitals are increasingly under fire for violating federal price transparency rules, with three facilities fined in the past five months as part of a renewed enforcement push by the Trump administration.

In May, the Centers for Medicare and Medicaid Services issued a $93,214 civil penalty to Community Care Hospital in New Orleans for repeated failures to post pricing information required under federal law. The agency found the hospital had no machine-readable pricing file online, failed to include key charge elements for shoppable services, and did not provide required website links or file formats.

Earlier this spring, Northlake Behavioral Health System in Mandeville was fined over $257,000 for similar violations.

Advocates say the surge in penalties highlights how far many hospitals remain from giving patients clear, upfront prices — and how Louisiana lags behind the rest of the country.

“Hospitals in Louisiana are falling short of the necessary federal price transparency requirements that have been in place since 2021,” Connie Partoyan, Executive Director at Better Solutions for Healthcare, told The Center Square. “With health care costs continuing to climb, Louisiana patients and employers have a right to know exactly what they’re paying for when they go to a hospital.”

Ilaria Santangelo, research director for PatientRightsAdvocate.org — a nonprofit watchdog group tracking hospital transparency — said such penalties are long overdue.

“Everyone’s gotten that medical bill in the mail and been flabbergasted,” Santangelo said in an interview with The Center Square. “We see prices vary tenfold in the same hospital for the same procedure, and over thirty times between hospitals in the same region.”

According to the group’s November 2024 compliance report, only 15% of Louisiana hospitals reviewed were fully compliant with the federal Hospital Price Transparency Rule — worse than the national average of 21.1%.

And just 13% of Louisiana facilities posted enough real, dollars-and-cents prices to allow meaningful price comparisons.

According to Santangelo, most hospitals in Louisiana are giving patients estimates or unintelligible algorithms instead of accountable prices.

“Most of the hospitals we looked at posted estimates or incalculable algorithms in lieu of actual prices, which made these pricing files unable to be shopped,” Santangelo said.

The price transparency rule, first enacted via a 2019 executive order by then-President Donald Trump, requires hospitals to post their negotiated rates, cash prices, and de-identified minimum and maximum charges in a machine-readable format. Though the Biden administration maintained the rule, Santangelo says it weakened enforcement and allowed hospitals to substitute actual prices with estimates or algorithms.

In practice, that rollback let hospitals obscure their prices behind averages and formulas that can’t be verified, Santangelo said. “President Trump’s reaffirming his commitment to real price transparency with his February executive order that in bold, required real prices and not estimates,” she said.

Under the revised Trump-era enforcement regime, hospitals must now attest — under penalty of law — that their pricing data is accurate and complete.

The administration also proposed a new rule in 2025 to eliminate the use of uncalculable estimates, tighten algorithm standards, and improve access to price data.

CMS can issue civil fines of up to $5,500 per day depending on a hospital’s bed count. According to Santangelo, only about 20 hospitals in noncompliance were ever fined over four years.

“Who knows why compliance is low, but hospitals were not meaningfully penalized enough for non compliance,” Santangelo said.

CMS itself has formally acknowledged a significant ramp‑up in its enforcement of hospital price transparency.

Under its April 26, 2023 enforcement update, the agency disclosed that it had expanded from roughly 30–40 to over 200 comprehensive pricing reviews per month, and had issued more than 730 warning notices and 269 corrective action plan requests as of April 2023.