{"schemaVersion":2,"hospital":{"key":"261302","name":"MADISON MEDICAL CENTER","displayName":"Madison Medical Center","displayCity":"Fredericktown","location":"FREDERICKTOWN, MO","identifiers":{"ccn":"261302","npi_type_2":"1720163025"}},"date":"2026-09-28","planKey":"national:2026-09-28:cdc5e7a710039c158be06a0521bcf44d9455bccf","publishedAt":"2026-09-29T05:48:53.466Z","summary":{"total":33,"passed":10,"failed":9,"blocked":0,"notApplicable":1,"couldNotDetermine":9,"notAssessed":4,"checked":19,"passRate":0.5263157894736842},"files":[{"runKey":"national-work:2026-09-28:cdc5e7a710039c158be06a0521bcf44d9455bccf:mrf-414b60214f57d73d59e9","evaluatedAt":"2026-09-28T07:25:08.937Z","sharedWithOthers":0,"sourceLinks":{"homepage":"https://madisonmedicalcenter.net/","cms_hpt_txt":"https://madisonmedicalcenter.net/cms-hpt.txt","current_mrf":"https://madisonmedicalcenter.net/431445493_Madison%20Medical%20Center_standardcharges.json","transparency_page":"https://madisonmedicalcenter.net"},"artifact":{"sha256":"01af781539488fb7a75ec1247e5bb7dd3b392972d2bb7e9838af9966c817c9c1","size_bytes":9814490,"display_size":"9.8 MB","display_format":"JSON","last_observed_change_at":"2026-09-27T19:39:10.001Z"},"ruleset":{"key":"hpt-v3","version":"catalog v2","dataDictionaryVersion":"3.0.0"},"summary":{"total":33,"passed":10,"failed":9,"blocked":0,"notApplicable":1,"couldNotDetermine":9,"notAssessed":4,"checked":19,"passRate":0.5263157894736842},"groups":[{"key":"attestation","rules":[{"title":"MRF correctly encodes the accuracy and completeness attestation","detail":"must have required property 'attestation'","result":"FAIL","ruleKey":"hpt.mrf.cms.attestation","authority":["45 CFR 180.50(a)(3)(iii)"],"statusLabel":"Failed","affectedRecordCount":1,"display":"FAIL"},{"title":"MRF correctly encodes the attester's name","detail":"The completed structural evaluation reported no deficiency for this nonconditional check.","result":"PASS","ruleKey":"hpt.mrf.cms.attester_name","authority":["45 CFR 180.50(a)(3)(iv)"],"statusLabel":"Passed","display":"PASS"}],"title":"Attestation and responsible official","groups":[],"result":"FAIL","authority":"45 CFR 180.50(a)(3)","statusLabel":"1 failed","distribution":{"FAIL":1,"PASS":1,"BLOCKED":0,"INDETERMINATE":0,"NOT_APPLICABLE":0},"display":"FAIL","displayCounts":{"FAIL":1,"PASS":1}},{"key":"hospital_mrf_information","rules":[{"title":"MRF declares this hospital's Type 2 NPI","detail":"The MRF does not declare a Type 2 NPI.","result":"INDETERMINATE","ruleKey":"hpt.mrf.identity.npi","authority":["45 CFR 180.50(b)(2)(i)(A)"],"statusLabel":"Couldn't determine","display":"COULD_NOT_DETERMINE","reason":"The hospital's file does not include a value this check needs."},{"title":"MRF correctly encodes its template version and update date","detail":"The value in this MRF's version data element \"2.2.0\" does not match the expected template version \"3.0.0\" for the data dictionary requirements selected for validation.","result":"FAIL","ruleKey":"hpt.mrf.cms.version_and_date","authority":["45 CFR 180.50(b)(2)(i)(B)"],"statusLabel":"Failed","affectedRecordCount":1,"display":"FAIL"}],"title":"Hospital and MRF information","groups":[],"result":"FAIL","authority":"45 CFR 180.50(b)(2)(i)","statusLabel":"1 failed","distribution":{"FAIL":1,"PASS":0,"BLOCKED":0,"INDETERMINATE":1,"NOT_APPLICABLE":0},"display":"FAIL","displayCounts":{"COULD_NOT_DETERMINE":1,"FAIL":1}},{"key":"standard_charges","rules":[{"title":"MRF lists a gross charge for every item and service","detail":"Gross charge values are populated on 3,378 charge objects and blank on 0 charge objects. The MRF alone cannot prove that every applicable hospital item or service is represented.","result":"INDETERMINATE","ruleKey":"hpt.mrf.gross_charges_complete","authority":["45 CFR 180.50(b)(2)(ii)"],"statusLabel":"Not assessed","display":"NOT_ASSESSED","reason":"The price file alone cannot answer this; it needs evidence from outside the file."},{"title":"MRF lists a discounted cash price for every item and service that has one","detail":"Discounted cash price values are populated on 3,378 charge objects and blank on 0 charge objects. The MRF alone cannot prove that every applicable hospital item or service is represented.","result":"INDETERMINATE","ruleKey":"hpt.mrf.cash_prices_complete","authority":["45 CFR 180.50(b)(2)(ii)"],"statusLabel":"Not assessed","display":"NOT_ASSESSED","reason":"The price file alone cannot answer this; it needs evidence from outside the file."},{"title":"MRF correctly encodes the de-identified minimum negotiated charge","detail":"The CMS validator reported 17938 errors about the charge rows that CareCarta could not attach to a specific check, so this check is not called clear. The errors are listed under template conformance.","result":"INDETERMINATE","ruleKey":"hpt.mrf.cms.minimum_charge","authority":["45 CFR 180.50(b)(2)(ii)"],"statusLabel":"Couldn't determine","display":"COULD_NOT_DETERMINE","reason":"The CMS validator reported problems CareCarta could not attribute to a specific check, so this one is not called clear."},{"title":"MRF correctly encodes the de-identified maximum negotiated charge","detail":"The CMS validator reported 17938 errors about the charge rows that CareCarta could not attach to a specific check, so this check is not called clear. The errors are listed under template conformance.","result":"INDETERMINATE","ruleKey":"hpt.mrf.cms.maximum_charge","authority":["45 CFR 180.50(b)(2)(ii)"],"statusLabel":"Couldn't determine","display":"COULD_NOT_DETERMINE","reason":"The CMS validator reported problems CareCarta could not attribute to a specific check, so this one is not called clear."}],"title":"Standard charges","groups":[{"key":"payer_specific","rules":[{"title":"MRF correctly encodes payer and plan names","detail":"The CMS validator reported 17938 errors about the charge rows that CareCarta could not attach to a specific check, so this check is not called clear. 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The errors are listed under template conformance.","result":"INDETERMINATE","ruleKey":"hpt.mrf.cms.methodology","authority":["45 CFR 180.50(b)(2)(ii)(B)"],"statusLabel":"Couldn't determine","display":"COULD_NOT_DETERMINE","reason":"The CMS validator reported problems CareCarta could not attribute to a specific check, so this one is not called clear."}],"title":"Payer-specific negotiated charge","groups":[{"key":"rate_expression","rules":[{"title":"MRF expresses each negotiated rate as a dollar amount, percentage, or algorithm","detail":"must NOT have fewer than 1 characters (reported 188 times).","result":"FAIL","ruleKey":"hpt.mrf.cms.rate_form","authority":["45 CFR 180.50(b)(2)(ii)(C)"],"statusLabel":"Failed","affectedRecordCount":188,"display":"FAIL"},{"title":"Percentage and algorithm rates give enough information to derive a dollar amount","detail":"13,543 percentage- or algorithm-based payer rates require semantic review of whether a reasonable user can derive a dollar amount.","result":"INDETERMINATE","ruleKey":"hpt.mrf.algorithm_derivable","authority":["45 CFR 180.50(a)(3)(iii)","45 CFR 180.50(b)(2)(ii)(C)"],"statusLabel":"Couldn't determine","display":"COULD_NOT_DETERMINE","reason":"This needs a person to judge; the automated check cannot decide it."}],"title":"Rate expression and methodology","groups":[{"key":"allowed_amounts","rules":[{"title":"MRF correctly encodes the 10th percentile allowed amount","detail":"must match \"then\" schema (reported 27,462 times). must have required property '10th_percentile' (reported 13,731 times).","result":"FAIL","ruleKey":"hpt.mrf.cms.allowed_p10","authority":["45 CFR 180.50(b)(2)(ii)(C)(2)"],"statusLabel":"Failed","affectedRecordCount":41193,"display":"FAIL"},{"title":"MRF correctly encodes the median allowed amount","detail":"must match \"then\" schema (reported 27,462 times). must have required property 'median_amount' (reported 13,731 times).","result":"FAIL","ruleKey":"hpt.mrf.cms.allowed_median","authority":["45 CFR 180.50(b)(2)(ii)(C)(2)"],"statusLabel":"Failed","affectedRecordCount":41193,"display":"FAIL"},{"title":"MRF correctly encodes the 90th percentile allowed amount","detail":"must match \"then\" schema (reported 27,462 times). must have required property '90th_percentile' (reported 13,731 times).","result":"FAIL","ruleKey":"hpt.mrf.cms.allowed_p90","authority":["45 CFR 180.50(b)(2)(ii)(C)(2)"],"statusLabel":"Failed","affectedRecordCount":41193,"display":"FAIL"},{"title":"MRF correctly encodes the count of allowed amounts","detail":"must have required property 'count' (reported 13,731 times). must match \"then\" schema (reported 27,462 times).","result":"FAIL","ruleKey":"hpt.mrf.cms.allowed_count","authority":["45 CFR 180.50(b)(2)(ii)(C)(2)"],"statusLabel":"Failed","affectedRecordCount":41193,"display":"FAIL"}],"title":"Allowed-amount statistics","groups":[],"result":"FAIL","authority":"45 CFR 180.50(b)(2)(ii)(C)(2)","statusLabel":"4 failed","distribution":{"FAIL":4,"PASS":0,"BLOCKED":0,"INDETERMINATE":0,"NOT_APPLICABLE":0},"display":"FAIL","displayCounts":{"FAIL":4}}],"result":"FAIL","authority":"45 CFR 180.50(b)(2)(ii)(C)","statusLabel":"5 failed","distribution":{"FAIL":5,"PASS":0,"BLOCKED":0,"INDETERMINATE":1,"NOT_APPLICABLE":0},"display":"FAIL","displayCounts":{"FAIL":5,"COULD_NOT_DETERMINE":1}}],"result":"FAIL","authority":"45 CFR 180.50(b)(2)(ii)(A)-(C)","statusLabel":"5 failed","distribution":{"FAIL":5,"PASS":0,"BLOCKED":0,"INDETERMINATE":3,"NOT_APPLICABLE":0},"display":"FAIL","displayCounts":{"COULD_NOT_DETERMINE":3,"FAIL":5}}],"result":"FAIL","authority":"45 CFR 180.50(b)(2)(ii)","statusLabel":"5 failed","distribution":{"FAIL":5,"PASS":0,"BLOCKED":0,"INDETERMINATE":7,"NOT_APPLICABLE":0},"display":"FAIL","displayCounts":{"NOT_ASSESSED":2,"COULD_NOT_DETERMINE":5,"FAIL":5}},{"key":"item_service","rules":[{"title":"MRF correctly encodes each item or service description","detail":"The CMS validator reported 17938 errors about the charge rows that CareCarta could not attach to a specific check, so this check is not called clear. 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The errors are listed under template conformance.","result":"INDETERMINATE","ruleKey":"hpt.mrf.cms.billing_code","authority":["45 CFR 180.50(b)(2)(iv)(A)-(B)"],"statusLabel":"Couldn't determine","display":"COULD_NOT_DETERMINE","reason":"The CMS validator reported problems CareCarta could not attribute to a specific check, so this one is not called clear."},{"title":"MRF lists every applicable modifier and its charges","detail":"The MRF was parsed for encoded modifiers, but the file alone cannot establish whether every applicable modifier-specific charge is represented.","result":"INDETERMINATE","ruleKey":"hpt.mrf.modifiers_complete","authority":["45 CFR 180.50(b)(2)(iv)(C)"],"statusLabel":"Not assessed","display":"NOT_ASSESSED","reason":"The price file alone cannot answer this; it needs evidence from outside the file."}],"title":"Billing and coding information","groups":[],"result":"INDETERMINATE","authority":"45 CFR 180.50(b)(2)(iv)","statusLabel":"1 couldn't be 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CFR 180.50(d)(5)"],"statusLabel":"Passed","display":"PASS"},{"title":"cms-hpt.txt is published and uses the required fields","detail":"The cms-hpt.txt file uses the required canonical fields and valid values.","result":"PASS","ruleKey":"hpt.txt.conforms","authority":["45 CFR 180.50(d)(6)(i)"],"statusLabel":"Passed","display":"PASS"},{"title":"cms-hpt.txt links this hospital's MRF","detail":"The cms-hpt.txt file declares one MRF (https://madisonmedicalcenter.net/431445493_Madison%20Medical%20Center_standardcharges.json), so it is this hospital's.","result":"PASS","ruleKey":"hpt.txt.links_mrf","authority":["45 CFR 180.50(d)(6)(i)"],"statusLabel":"Passed","display":"PASS"},{"title":"Homepage has a link labelled Price Transparency","detail":"A labeled Price Transparency link (https://madisonmedicalcenter.net/price-transparency-initiative-charges-listing/) was observed in the acquired hospital homepage HTML.","result":"PASS","ruleKey":"hpt.website.price_transparency_link","authority":["45 CFR 180.50(d)(6)(ii)"],"statusLabel":"Passed","display":"PASS"}],"title":"Publication and accessibility","groups":[],"result":"PASS","authority":"45 CFR 180.50(d)(1)-(6)","statusLabel":"Passed","distribution":{"FAIL":0,"PASS":9,"BLOCKED":0,"INDETERMINATE":0,"NOT_APPLICABLE":0},"display":"PASS","displayCounts":{"PASS":9}},{"key":"update_frequency","rules":[{"title":"MRF was updated within the past 12 months","detail":"The MRF reports 2025-01-05, more than one year before this audit observation.","result":"FAIL","ruleKey":"hpt.mrf.updated_within_year","authority":["45 CFR 180.50(e)"],"statusLabel":"Failed","display":"FAIL"}],"title":"Update frequency","groups":[],"result":"FAIL","authority":"45 CFR 180.50(e)","statusLabel":"1 failed","distribution":{"FAIL":1,"PASS":0,"BLOCKED":0,"INDETERMINATE":0,"NOT_APPLICABLE":0},"display":"FAIL","displayCounts":{"FAIL":1}},{"key":"shoppable_services","rules":[{"title":"Website offers a qualifying shoppable-services list or price 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enforcement records were not evaluated in this bounded audit.","status":"NOT_EVALUATED"},"hospitalResponse":{"detail":"No hospital response is recorded for this bounded audit.","status":"NONE_RECORDED"}}