Massachusetts hospitals must meet the federal machine-readable file (MRF) requirement under 45 CFR 180.50 — and Massachusetts layers its own rules on top: Massachusetts Chapter 224 requires hospitals to publish price information and the Center for Health Information and Analysis (CHIA) publishes comparative hospital pricing data. With ~116 hospitals in the state, CMS's 2026 AI-enabled audit ramp means non-compliant files in Massachusetts are more likely than ever to convert a warning letter into a $5,500/day fine.
Massachusetts hospitals face both federal MRF requirements and CHIA's state data submissions; the state is among the most active in healthcare price transparency policy.
Federal baseline: 45 CFR Part 180 still applies to every Massachusetts hospital regardless of state rules. Missing either track is an exposure.
| Hospitals in Massachusetts | ~116 |
| State law | MA Chapter 224 — Health Care Cost Transparency |
| Federal exposure | $5,500/day per violation under 45 CFR 180.50 |
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