What the FTC's review rules mean for a practice.

The practical change is enforcement. Before the rule, the FTC brought these cases one at a time under the FTC Act. The rule lets the agency seek civil penalties against knowing violators, which the Commission said plainly was the point: case-by-case enforcement without civil penalty authority might not be enough to deter clearly deceptive review practices.[1]

The rule prohibits six things. Each one below is the FTC's category, followed by what it tends to look like inside a practice.

1. 01

   Fake reviews and testimonials, including the AI-written kind [1]

   The rule covers reviews and testimonials that misrepresent who wrote them: someone who does not exist, someone who never had an actual experience with the business, or someone whose experience is misstated. It prohibits creating them, selling them, buying them, sourcing them from company insiders, and passing them along when the business knew or should have known they were fake. For a practice, the exposure is almost always that last one. A vendor supplies the reviews, the practice publishes them, and should have known is the standard the practice is measured against.

2. 02

   Paying for a particular sentiment [1]

   Compensation or incentives conditioned on a review that expresses a particular sentiment are prohibited, positive or negative. The rule says the condition can be conveyed implicitly, so it does not have to be written down anywhere to count. Asking patients for reviews is not the problem. Offering something in exchange for a five-star one is the thing the rule names.

3. 03

   Reviews written from inside the practice [1]

   Reviews and testimonials by officers and managers are prohibited when they fail to disclose the writer's material connection to the business clearly and conspicuously. The rule reaches past the owner: it also sets requirements when officers or managers solicit reviews from their own immediate relatives, or from employees and agents, or when they tell employees to solicit reviews from relatives. In a clinic the common version of this is staff reviewing their own workplace.

4. 04

   A review site you control that presents itself as independent [1]

   A business may not misrepresent that a website or entity it controls provides independent reviews or opinions about a category that includes its own services. The shape to watch for is a best surgeons in the city page, run by the practice or its vendor, that reads as neutral and happens to rank the practice first.

5. 05

   Suppressing the reviews you did not want [1]

   Two separate things are prohibited. First, using unfounded or groundless legal threats, physical threats, intimidation, or certain false public accusations to prevent or remove a negative review. Second, misrepresenting that the review section of your site holds all or most of the reviews submitted when reviews have been suppressed by rating or by sentiment. The second one is what catches ordinary businesses, because it usually lives as a default setting inside a reputation tool rather than a decision anyone remembers making.

6. 06

   Bought followers and views [1]

   Selling or buying fake indicators of social media influence, such as followers or views generated by bots or hijacked accounts, is prohibited where the buyer knew or should have known the indicators were fake and they misrepresent the buyer's influence or importance for a commercial purpose.

The case that came first

The precedent worth reading is Fashion Nova. In January 2022 the company agreed to pay $4.2 million to settle FTC allegations that it blocked negative reviews of its products from being posted to its website. It used a third-party review management interface that automatically posted four and five star reviews and held lower-starred ones for approval, and from late 2015 until November 2019 it never approved or posted the hundreds of thousands that were held. The FTC called it the agency's first case involving a company's efforts to conceal negative customer reviews.[3]

Two details from that announcement matter more to a practice than the headline number. The FTC sent letters to ten companies offering review management services, putting them on notice that avoiding the collection or publication of negative reviews violates the FTC Act. And three months earlier the Commission had warned more than 700 businesses that they could incur significant civil penalties for using reviews or endorsements in ways found unlawful in prior cases. The tooling was put on notice, and so were the businesses buying it.[3]

Four questions for whoever runs your reviews

• Does any tool you run for us filter, gate, or hold reviews by star rating or by sentiment? Ask for the answer in writing, and ask what the default setting is.
• What happens to a one-star review from the moment it is submitted? Walk me through it.
• Has anyone at your company ever written, bought, or sourced a review for a client?
• What exactly does the reputation management line on our invoice buy?

A vendor that cannot answer the first two quickly is telling you it does not know what its own tool does, and the rule reaches the practice whose name is on the reviews. This is a summary of a public rule and not legal advice. The rule itself is linked below, and your counsel is the right reader for your situation.

This is the second of these notes. The first is what to ask before signing any marketing contract, and the wider decision starts at how to choose practice marketing.

Sources

1. [1] FTC press release, 14 August 2024: 'Federal Trade Commission Announces Final Rule Banning Fake Reviews and Testimonials' (the six prohibited categories, quoted above; Commission vote 5-0)
2. [2] Federal Register, 'Trade Regulation Rule on the Use of Consumer Reviews and Testimonials' (16 CFR Part 465): published 22 August 2024, effective 21 October 2024
3. [3] FTC press release, 25 January 2022: 'Fashion Nova will Pay $4.2 Million as part of Settlement of FTC Allegations it Blocked Negative Reviews of Products'

All three are primary documents from the FTC and the Federal Register. This page was last reviewed on 2026-09-26; if you find a claim that no longer holds, write to us and we will correct it.