In June, the U.S. Department of Health and Human Services named 519 hospitals nationwide who have failed to follow federal pricing transparency rules, a rarity for a government agency. Four of those hospitals are in Maryland: Levindale Hebrew Geriatric Center and Hospital in Baltimore; TidalHealth Atlantic, formerly Atlantic General Hospital, in Berlin; Western Maryland Hospital Center in Hagerstown; and Adventist HealthCare Shady Grove Medical Center in Rockville.
This should embarrass Maryland more than most states. Maryland is the only state in the country where a government commission already sets hospital rates, although this is set to change in 2028 with the imposition of the federal Achieving Healthcare Efficiency through Accountable Design (AHEAD) Model.
The Health Services Cost Review Commission has been regulating what Maryland hospitals charge since the 1970s, and every HSCRC-regulated hospital already builds, files, and updates detailed rate information as a matter of routine. No hospitals in America are better positioned to meet federal transparency requirements. Yet clearly some still don’t, and Maryland patients and families suffer as a result.
Some in Annapolis will be tempted to dismiss these citations as federal theater with little relevance to a rate-regulated state. But rate regulation is not the same as affordability, and it certainly does not make care easy for patients to navigate. A March 2026 UMBC poll found that 57 percent of Marylanders said healthcare had become less affordable over the previous year. In 2025, a UMBC poll found that 34 percent of Marylanders said they or someone in their household had avoided medical care because of cost in the previous year.
Patients need to know
Maryland may set the rates hospitals can charge for now, but patients still need to know what they will actually pay — before they get care, not after the bill arrives. As the state transitions to the AHEAD model, ensuring pricing transparency remains front in center must be a top priority for state legislators.
So what is going on with the cited hospitals? Some have said the problems were technical. Levindale, for example, attributed its notice to a file-labeling issue it has since corrected, and hospitals nationwide have offered similar explanations: formatting glitches, not missing prices. But a technical explanation does not erase the underlying issue or hospital obligation. Hospitals routinely manage complex filings tied to payment and regulation without error. Pricing information that patients depend on deserves the same level of care.
This should not come as a surprise to hospital systems in Maryland or otherwise. President Trump signed an executive order in 2019 directing HHS to require hospitals to make their prices public. The rule took effect in January 2021 and survived a court challenge from the hospital industry. This January, CMS tightened the requirements further, demanding more complete pricing data and certification of its accuracy — with penalties that can reach roughly $2 million per hospital per year. HHS Secretary Robert F. Kennedy Jr. and CMS Administrator Mehmet Oz have made clear that the grace period is over.
There is a broader principle here, one I saw repeatedly during my time with the FDA: disclosure can change behavior because it creates accountability. That is also the premise behind the federal hospital price transparency rules. Hospitals must publish prices in a standardized, machine-readable format that lets patients, employers, researchers, and journalists compare what hospitals charge. Transparency only works, though, if the information is complete, accessible, and accurate. A price file that exists but cannot be found or read protects no one.
Maryland should set the standard
Maryland should be setting the standard here, not explaining why it fell short. The state already has one of the stronger healthcare systems in the country, ranking seventh nationally in the Commonwealth Fund’s 2025 assessment of state health systems. It saw widespread bipartisan support in the state legislature last year in support of SB0832/HB1136 which would have required nonprofit hospitals to be more transparent in their community benefits, making clear the value of their community benefit spending and towards what. This push for transparency fits a longer tradition: Maryland has spent decades building a hospital system around regulation, oversight, and public accountability.
That legacy matters even more now with the imposition of the federal AHEAD Model. As the state redesigns how it pays hospitals, accurate and usable pricing information should be built in from the start — a basic feature of the system, not an afterthought corrected under federal pressure.
While the hospitals cited need to correct their immediate problems, the greater opportunity is to make accurate, usable pricing information a basic part of Maryland’s healthcare system going forward. Patients should know what care will cost before they receive it. Maryland has the experience and infrastructure to get this right.
Peter J. Pitts is a former FDA Associate Commissioner and President and Co-Founder of the Center for Medicine in the Public Interest.
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