Steps

Retrieve the hospital's root-level TXT index file (linked from the hospital homepage per the CMS requirement) to discover the current MRF URL and confirm the link is present and resolving.
Download the MRF header section and extract the last_updated date; compare it to a 30-day staleness threshold (CMS requires monthly updates) and alert if the file has not been updated within that window.
Run the CMSgov/price-transparency-guide-validator (or equivalent schema check) against the MRF to detect structural or schema compliance failures.
Verify that required 2026 fields — including the attestation block with senior official name and Type 2 NPI — are present in the file.
Log the compliance check results with timestamps to a monitoring store and generate alerts to the compliance team when any check fails.
Schedule the monitoring pipeline to run at least weekly, as CMS enforcement inspectors also perform automated checks and civil monetary penalties apply for non-compliant hospitals.

Known gotchas

Some hospitals update the last_updated date in the file header without actually refreshing the underlying data; a date check alone is insufficient — also check file hash or size against prior runs to detect cosmetic-only updates.
CMS enforcement uses automated tools to detect missing or non-compliant MRFs; compliance failures that persist beyond 90 days without correction can trigger a corrective action plan request.
Hospitals with multiple CCNs (Medicare provider numbers) or campuses may be required to publish separate MRFs for each location; monitoring a single file per hospital system may miss compliance gaps at individual campus level.

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Configure automated CMS MRF compliance monitoring to detect when a hospital's machine-readable file is missing, stale, or fails schema validation

Steps

Known gotchas

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