On October 5, 2026, Federal Trade Commission (FTC) Chairman Andrew N. Ferguson sent warning letters to 24 of the largest hospital systems in the nation, illustrating the all-of-government approach to fighting fraud and deception in the healthcare industry. The letters mark the agency's most direct move yet into hospital pricing, using a playbook it has already successfully used in other industries, as illustrated by recent landmark settlements in the technology industry. The letters note that failure to publicly post pricing information for routine and non-emergency healthcare services may result in enforcement attention from both the Centers for Medicare & Medicaid Services (CMS) and FTC antitrust authorities charged with enforcing fair pricing regulations. 

The FTC letters are only the latest indicator of the federal government's sweeping focus on the healthcare industry, which include Chairman Ferguson's formation of a Healthcare Task Force in March 2026, leveraging resources of the FTC in partnership with the Departments of Health and Human Services (HHS) and Justice (DOJ). The letters also closely follow the October 1 announcement by the DOJ's newly created National Fraud Enforcement Division (Fraud Division) identifying healthcare fraud as the number one corporate enforcement priority of the division. Industry participants are on notice that federal unfair trade practices laws are yet another lever that the government will pull to target unjust or non-transparent business practices by healthcare providers. 

The Government's Increasing Focus on Healthcare Price Transparency

In 2019, the first Trump administration issued Executive Order (E.O.) 13877, directing the HHS to require hospitals to publicly disclose pricing information for certain identified "shoppable services," focusing on routine and non-emergency medical care scheduled in advance of treatment. Following this order, CMS issued the Hospital Price Transparency rule, which went into effect in January of 2021, directing hospitals to publicly post pricing information for identified services. 

The current administration has aggressively worked to add teeth to the 2021 CMS rule. E.O. 14221, issued in February 2025, declared that "progress on price transparency at the Federal level [had] stalled," and directed the Secretaries of the Treasury, Labor, and HHS to take prompt action to enforce price transparency requirements. That order specifically emphasized that healthcare providers must disclose "actual prices" for items and services, rather than estimates, and called for updates to guidance and enforcement policies to address providers who failed to comply.

Corporate officers are also on the hook. CMS's latest updates demand that hospitals also submit an "Attestation Statement" in the name of the hospital CEO, president, or senior official responsible for overseeing data encoding, attesting to the accuracy of pricing representations. 

Increased enforcement has followed E.O. 14221. Of the 25 entities fined for failure to comply with CMS price transparency requirements since 2021, more than one third of the penalties were issued since the start of the new administration in January of 2025.

FTC's Hospital Letters

The FTC's October 5 letters underscore that past fines levied by CMS may only be a prelude to more extensive future enforcement actions. They characterize CMS's price transparency rules as "a foundation" for pricing requirements and a "regulatory floor," while emphasizing that compliance with CMS requirements will not insulate healthcare providers from liability under Section 5 of the FTC Act, which prohibits unfair or deceptive acts or practices in the marketplace more broadly. 

The hook for potential investigations is straightforward: the letters state that because the price for medical services is a material term under the FTC Act, those prices must be clearly and conspicuously disclosed without regard to whether the services are specifically enumerated in CMS regulations. The letters further state that even when price terms are disclosed, they may still be deceptive and in violation of the FTC Act if they omit certain charges such as physician or facility fees, or if they are otherwise incomplete or misleading. 

The letters also note that failing to post transparent price information could be "unfair" under the FTC Act "if it causes or is likely to cause substantial injury to consumers that is not reasonably avoidable by consumers themselves and is not outweighed by countervailing benefits to consumers or competition." The letters specifically say that "incomplete, inaccurate, or untimely pricing disclosures" obstruct consumers from making informed decisions and offer no countervailing benefits to competition or consumers. 

Considering these regulatory requirements and enforcement priorities, Chairman Ferguson urged healthcare companies to conduct a "comprehensive review" of price disclosure practices to ensure that consumers are provided timely, accurate, and complete pricing information for healthcare services, and to take swift corrective action where needed. 

Focus on Price Transparency Across the Healthcare Industry

Hospitals are not the only healthcare-related entities targeted for FTC scrutiny this week. The FTC letters are aligned with a new insurer price transparency rule finalized on October 5, 2026, by HHS and the Department of Labor (DOL), which seeks to standardize file formats and eliminate junk data in order to make healthcare price information more accessible to the public and increase accountability for insurers who fail to comply. That rule confirms that insurers, like healthcare providers, should expect increased regulatory attention to their pricing disclosures going forward. 

Threat of Cross-Government Enforcement

The FTC hospital letters heighten the risk of future enforcement actions by the FTC impacting the healthcare industry. The letters note that the FTC will continue to monitor the healthcare marketplace and take enforcement action where warranted. Areas of enforcement focus identified in the letter include specific "vulnerable populations, including rural Americans, seniors, and veterans" who lack access to affordable and transparent healthcare services. 

Enforcement efforts focused on the healthcare industry extend well beyond FTC and are likely to leverage resources from HHS, the DOJ, and even state regulatory and law enforcement officials. The letters note that the FTC has prioritized investigating and prosecuting deceptive and unfair practices in the healthcare industry, including through the FTC Healthcare Task Force announced earlier this year. The FTC announcement also highlights its recent initiation of a lawsuit against online contact lens provider Lens.com for allegedly misrepresenting contact lens prices in search ads and on its website.

The FTC letters are also consistent with ongoing efforts across the government to seek out fraud, waste, and abuse in every aspect of the healthcare industry. Miller & Chevalier previously reported on the DOJ's increasing use of healthcare-focused strike forces leveraging advanced data analytics to target the healthcare industry. Those efforts have already helped generate a wave of federal fraud investigations and settlements that shows no sign of abating. 

Compliance Takeaways

Hospitals and other healthcare-industry participants are advised to be proactive in preparing for FTC scrutiny. Those preparations should include the following:

Triple-Check Pricing Data: CMS regulations emphasize the publication of accurate, transparent, and readily available pricing data for public perusal. Federal task forces like the FTC's are increasingly adept at using data-scraping tools and computer-assisted analysis to search for inaccuracies and outliers. Hospitals' in-house teams should dedicate the resources required to ensure that data is current, accurate, and comprehensive. 

Ensure that Disclosures Reflect How Services are Charged in Practice: The FTC letters warn that disclosures may be deceptive if they omit costs such as physician fees, facility fees, or aspects of patient care that are typically bundled together for consumers. Hospitals should review their actual billing practices to ensure that prices reflect such bundled services, even when charges are separately billed.

Show Your Work: Hospitals should be prepared to explain to CMS or the FTC how they determined the accuracy of published prices. In-house teams should document data sources reviewed, validation procedures, and safeguards applied to identify errors or omissions. The goal is to be able to prove, on request, that diligent efforts were made to comply with regulatory requirements.

Stay Current: The letters indicate that the FTC is only just beginning to exercise its enforcement authority in the healthcare arena. Future actions taken and complaints filed will provide clues about areas of particular interest or recurring vulnerabilities among regulated entities. Miller & Chevalier will continue to report on key developments as the FTC establishes itself as a powerful new player on this field. 

For more information, please contact:

Kevin Lowell, klowell@milchev.com, 202-626-5837

Bradley E. Markano, bmarkano@milchev.com, 202-626-6061

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