Issue background
A healthcare organization received a compliance warning from the Centers for Medicare & Medicaid Services (CMS) regarding its hospital price transparency files. Although the organization hosted machine-readable pricing data (MRF) in CSV format on its website, the files were not discoverable by automated CMS tools. CMS requires that hospitals maintain both a machine-readable pricing file and an accompanying cms-hpt.txt file that allows regulators to verify and validate the data automatically.
Initially, the website contained links to CSV files for each facility, but there was no properly formatted reference file in the domain root or .well-known directory. This caused the CMS validator to flag the site as noncompliant.
Diagnosis
Upon reviewing the site and CMS documentation, Freshy’s development team determined that:
- The existing MRFs were hosted in CSV format but lacked a reference file (
cms-hpt.txt) required by the Hospital Price Transparency Rule. - The original
.txtfile on the server used an outdated schema and an incorrect filename (cms-price-transparency.txt). - Each hospital location—such as the primary medical center and its affiliate—needed to be listed separately within the file using the current CMS key:value format.
- The
.txtfile must be located either at the root of the website (/cms-hpt.txt), or within a hidden.well-knowndirectory (/.well-known/cms-hpt.txt), per CMS guidance. - The “Machine Readable File” buttons on the public-facing pages needed clearer labeling and direct links to the corresponding files.
Resolution steps
Freshy’s developers carried out the following updates to bring the site into full compliance:
- Created a compliant
cms-hpt.txtfile in the site root, following the official CMS format. Example code block:
location-name: Example Medical Center
source-page-url: https://example.org/patients/paying-for-your-care/medical-center/
mrf-url: https://example.org/files/standard-charges-medical-center.csv
contact-name: Compliance Officer
contact-email: compliance@example.org
location-name: Example Community Hospital
source-page-url: https://example.org/patients/paying-for-your-care/community-hospital/
mrf-url: https://example.org/files/standard-charges-community.csv
contact-name: Compliance Officer
contact-email: compliance@example.org
- Verified file accessibility using both direct URL access and CMS validation tools to ensure the MRFs were publicly reachable without authentication or redirects.
- Added clear labeling for each facility on the site’s “Paying for Your Care” pages, ensuring users could distinguish between each hospital’s pricing file:
- Button: “Medical Center (MRF)”
- Button: “Community Hospital (MRF)”
- Tested server compatibility with the
.well-knowndirectory option. In this case, root-level placement was used for simplicity and consistency with CMS scanning tools. - Finalized links and validated compliance, confirming that both CSV and TXT files loaded correctly and passed CMS’s automated discovery requirements.
Final outcome
After implementing the corrections, the website achieved full compliance with CMS price transparency regulations. The updated cms-hpt.txt file correctly references both facilities and provides automated accessibility for CMS audits. Clear, labeled buttons now direct users to each hospital’s machine-readable pricing file.
This fix not only resolved the compliance warning but also improved the site’s accessibility and clarity for patients seeking pricing information.
Key takeaway
Hospitals and healthcare systems should routinely audit their pricing transparency pages to ensure both human-readable and machine-readable access meet the latest CMS standards. The cms-hpt.txt file—often overlooked—is essential for compliance validation.
If your organization has received a CMS noncompliance notice or needs help implementing pricing transparency requirements, contact Freshy for expert WordPress development and compliance support.
