The White House published a new executive order on February 25, 2025, that directs federal agencies to enforce previously-existing healthcare price transparency regulations. This action reaffirms the commitment to make healthcare prices accessible to patients and researchers.

The directive instructs federal departments to create a strong framework for enforcement within 90 days, with a particular focus on hospital compliance. It includes the potential to “issue guidance or proposed regulatory action updating enforcement policies designed to ensure compliance with the transparent reporting of complete, accurate, and meaningful data.”

Here’s what you need to know about this new EO and its impact on provider data requirements.

The Key Points of the Latest Price Transparency Executive Order 

The new executive order focuses on enforcing existing price transparency requirements that were established in 2019. Federal agencies have 90 days to create stronger enforcement frameworks that ensure hospitals and health plans comply with their disclosure obligations.

The order emphasizes that disclosed pricing data must be actual prices, not estimates, and presented in standardized formats that consumers can easily compare across facilities. It also directs agencies to issue guidance or proposed regulatory action to verify that published data is complete, accurate, and meaningful.

While the executive order addresses enforcement for both hospitals and health plans, industry observers note that compliance efforts will likely target hospitals more intensively.

Industry Implications – Keywell Perspective

Keywell started processing the health plan (payer) machine-readable files in 2022, just after the transparency regulation went into effect. We learned that the files are an incredibly rich source of information on healthcare prices (resulting in the development of our Pricelink™ market analysis tool). 

We also discovered that the payers were publishing rates that were clearly wrong and often irrelevant. Keywell developed the Keywell Relevance Score to help validate rates and sort out the noise. However, better enforcement would go a long way to achieving the consumer and cost-saving aims of the administration. We submitted a Freedom of Information (FOIA) request in early 2023 to learn about the reported issues with the files and intended enforcement actions, but the request is still pending action.

Keywell believes the administration’s likely focus on hospital compliance misses an opportunity to address the (more important) data source — the payer-negotiated rates. 

Payer data should include all hospital rates anyway. But payer data goes further by also covering outpatient and non-hospital services, including those owned by hospitals. This makes payer data more comprehensive and valuable for analysis.

Health plan systems provide a more reliable source of pricing information for several reasons:

• They are directly responsible for payments to providers
• They maintain uniform systems that track these payments
• They manage broad swaths of provider contracts

Hospitals, in contrast, must manage individual contracts with multiple payers, which creates consistency challenges and makes their data less comprehensive.

Some patient advocacy groups have directed attention to hospital non-compliance, but we find this focus puzzling. The hospital data is less comprehensive and theoretically redundant with what payers already report. There is known to be limited agreement between hospital and payer pricing information due to differences in data formats and reporting requirements.

Optimistically, the administration will address some key issues with the health plan MRF files, including:

• Under-reporting of rates for relevant NPIs
• Inclusion of rates for providers who would never bill the reported procedure code based on their scope of practice
• Inconsistent plan ID and HIOS numbers that makes it difficult to identify which plan is referenced
• Multiple rates provided for a given provider and procedure code without any explanation

Bipartisan Support for Transparency

Healthcare price transparency in healthcare has received consistent support across multiple administrations. The recent executive order builds on regulations first established in 2019.

While implementation has faced challenges, the commitment to transparency has remained a priority for both Republican and Democratic leadership. 

This latest executive order aims to address compliance gaps by directing the Departments of Treasury, Labor, and Health and Human Services to create stronger implementation frameworks.

What This Means for Your Organization

If guidelines are enforced as claimed in the executive order, this dataset has the potential to be impactful in reducing employer costs and achieving price transparency for consumers.

We expect price transparency regulations will continue to evolve, and we’re watching for (and hoping to see) enforcement actions directed at health plans in addition to hospitals. This would create a more balanced approach to improving data quality across the entire healthcare system.

The renewed enforcement action confirms that this is an ongoing priority and that the data is here to stay, creating valuable market opportunities for organizations ready to leverage it.

If you’re a provider group looking to analyze market rates or explore new territories, we can help you extract valuable insights from payer data.

If you’re a technology company trying to integrate pricing information into your solution, we understand the challenges you face with data quality and can provide reliable price transparency analytics.

Contact us to discuss how we can support your price transparency data needs.