Hospital price transparency
Civil monetary penalties: amounts and limits
Hospital price transparency penalties use a bed-count scale, but the base amounts in 45 CFR 180.90 are not a current-dollar quote. The rule specifies $300 per day for hospitals with 30 or fewer beds, $10 per bed per day for 31-550 beds, and $5,500 per day above 550 beds, with annual inflation adjustment under part 102.
The current 45 CFR 102.3 table lists adjusted maximums of $342 per day for 30 or fewer beds, $11 per bed per day for the middle band, and $6,277 per day above 550 beds. HHS's October 21, 2026 notice says there is no 2026 inflation adjustment and the 2025 adjusted levels continue. Do not substitute an old $300-$5,500 summary for this dated table, or extrapolate a case total without the applicable notice and period.
CMS normally uses the most recently available finalized Medicare hospital cost report for bed count. If that source cannot establish the count, CMS can request documentation. Failure to provide it in the prescribed form, manner and time can lead to use of the highest daily maximum. A penalty notice also identifies the effective violation date and amount; continuing violations can lead to subsequent notices.
A 35% reduction is conditional, not automatic for every hospital: the hospital must affirmatively request a hearing waiver in writing within 30 calendar days of the notice. It is unavailable when the CMP is imposed for failure to publish an MRF or any qualifying consumer-friendly disclosure. A subsequent CMP for the same instance(s) of noncompliance does not receive an additional 35% reduction. The waiver also reaches appeal rights for those continuing-violation CMPs. Counsel should review that choice and the notice-specific payment obligations.
Sources
- 45 CFR 180.90
- 45 CFR 102.3, adjusted penalty table
- HHS October 21, 2026 inflation notice
- CMS HPT FAQs, enforcement and appeals