Compliance Audit & Gap Analysis
We review your existing MRF files and consumer-facing displays against the current CMS requirements — identifying every gap before CMS does.
Compliance
Healthcare Price Transparency Compliance — Done Right
CMS enforcement is escalating. SumHealth gives hospitals and health systems the tools and expertise to achieve compliance, stay audit-ready, and protect against civil monetary penalties.
The Stakes
CMS Is Enforcing. The Penalties Are Real.
The Hospital Price Transparency Rule requires hospitals to publish machine-readable files and consumer-friendly displays for all standard charges. Non-compliant hospitals face civil monetary penalties up to $2 million per year — and CMS is actively issuing warning letters and enforcement actions.
$300/day
Penalty rate for hospitals under 30 beds
$10/day
Per bed for larger hospitals (up to $5,500/day)
$2M/yr
Maximum annual civil monetary penalty
Our Services
End-to-End Compliance Support
MRF File Generation & Remediation
We generate or remediate your machine-readable files to meet the CMS schema requirements — including all required data elements for every standard charge.
Ongoing Compliance Monitoring
Automated checks that flag issues as your charge data changes — so your files stay compliant 365 days a year, not just at implementation.
Consumer-Facing Display
A compliant, user-friendly shoppable services display embedded on your hospital website — meeting the plain-language and searchability requirements.
Enforcement Response Support
Received a CMS warning letter or corrective action plan request? We provide expert support to draft your response and achieve compliance fast.
Staff Training & Documentation
We train your revenue cycle and compliance teams on the requirements, establish internal governance, and document your compliance program.
What's Required
The CMS Price Transparency Rule at a Glance
The Hospital Price Transparency Rule took effect January 1, 2021 and has been updated with increasing stringency since. Here's what every hospital must have in place:
- Machine-Readable File (MRF)
A comprehensive, publicly available file with all standard charges — including gross charges, discounted cash prices, payer-specific negotiated rates, and de-identified min/max rates.
- Consumer-Friendly Display
A searchable, plain-language display of at least 300 shoppable services on your public website — accessible without registration or login.
- Schema Compliance
Files must conform to the CMS Technical Implementation Guide — specific JSON/CSV schema, required fields, and encoding standards that are updated periodically.
- Ongoing Accuracy
Files must be updated at least annually or whenever rates change materially. Stale or inaccurate data is itself a compliance violation.
Why SumHealth
We've Processed Hospital MRFs Nationwide. We Know What Good Looks Like.
Nationwide Data Coverage
SumHealth processes hospital MRF files from across the country. We've seen the schema errors, edge cases, and enforcement patterns that trip hospitals up.
Enforcement Intelligence
We monitor CMS enforcement activity and rule updates in real time — so your compliance posture evolves as the regulatory environment does.
Fast Time to Compliance
Our automated tooling and expert team get most hospitals to full compliance within 30–60 days — significantly faster than internal remediation efforts.
Ongoing Partnership
We don't disappear after implementation. Continuous monitoring, annual updates, and responsive support keep you compliant year-round.
Who It's For
Is Your Hospital at Risk?
CMS has identified thousands of non-compliant hospitals. If any of the following apply to your organization, it's time to act.
Request a Free Compliance Review- You've received a CMS warning letter or corrective action plan request
- Your MRF was published more than 12 months ago without updates
- You're unsure if your file meets the current CMS schema requirements
- Your consumer-facing shoppable services display is missing or incomplete
- You're part of a health system and haven't audited all member hospitals
- No one internally owns compliance monitoring on an ongoing basis
Don't Wait for CMS to Come Knocking
Our compliance team will review your current status and give you a clear picture of where you stand — at no cost. From there, we'll build a remediation plan that fits your timeline and budget.
Request Your Free Compliance Review