What is the FTC Consumer Review Rule?
It is a federal trade regulation, 16 CFR Part 465, formally the Trade Regulation Rule on the Use of Consumer Reviews and Testimonials. The Commission approved it 5-0 in August 2024 and it took effect on October 21, 2024.1 Deceptive reviews were already illegal under the FTC Act. What changed is that a written rule lets the FTC seek civil penalties from businesses that break it knowingly, instead of only ordering them to stop.1
The amount matters because it is per violation. In December 2025 the FTC sent warning letters to 10 companies and reminded them that violations can bring civil penalties of up to $53,088 per violation.4 Those letters were not findings of a violation. The rule covers any business that sells a product or a service, which includes a chiropractic office, a dental practice and a solo health coach.
What exactly does the rule ban?
Six things, in the rule’s own sections.2 For a practice, four of them come up in real life:
- Fake reviews. Writing, buying or publishing a review that misrepresents who wrote it, whether that person was ever a patient, or what their experience was. The FTC’s announcement names AI-generated fake reviews specifically.1
- Paying for a particular opinion. Any compensation or incentive "conditioned expressly or by implication" on a positive or a negative review.2
- Insider reviews. An owner or manager reviewing their own practice without a clear disclosure, and managers soliciting reviews from relatives or staff that then appear without that disclosure.2
- Review suppression. Using an unfounded legal threat, intimidation, or a knowingly false public accusation to stop a review or get one taken down.2
The other two cover company-controlled "independent" review sites and fake followers or views.2
Can a practice still ask patients for reviews?
Yes, and it should. The FTC’s own guidance says the rule does not prohibit incentives for reviews "as long as there isn’t an express or implied requirement that the reviews have to express a particular sentiment".3 The trap is the implied part. The FTC’s example is a message offering a coupon to "tell us how much you loved your visit", which signals that only a happy review earns the reward.3 A text that says "tell us how your visit went" does not.
Google is stricter than the FTC. Its policy for reviews on Maps and Business Profiles forbids businesses to offer incentives such as payment, discounts, or free goods or services in exchange for posting any review, positive or not.5 Since most practice reviews live on Google, the practical rule is simple: ask, do not pay.
Is review gating illegal now?
Review gating means sending a short survey first and only asking the patients who answer "great" to post publicly. The rule has no section that names it. The FTC’s guidance addresses it directly anyway: the rule "does not contain a specific prohibition against such conduct. But this practice could violate the FTC Act", pointing to the Endorsement Guides.3 Google’s policy forbids it outright, in the words "selectively solicit positive reviews".5
My position: gating is not worth the risk. It invites an FTC Act claim, breaks Google’s terms, and produces a star rating that patients and AI assistants read as a fact about you when it is really a fact about your filter. A 4.6 built from everyone is worth more than a 4.9 built from the people you chose. More on why star ratings feed AI answers is in the guide to becoming the practice AI recommends.
| What the practice does | FTC rule | Google policy |
|---|---|---|
| Asks every patient to leave a review | Allowed | Allowed |
| Offers a gift card for any review, good or bad | Allowed | Not allowed |
| Offers a gift card for a 5-star review | Banned | Not allowed |
| Asks only patients who scored a survey highly | Could violate the FTC Act | Not allowed |
| Front desk staff review the practice, undisclosed | Banned | Not allowed |
| Threatens to sue over a fair negative review | Banned | Not allowed |
What about reviews on the practice’s own website?
If your site shows a reviews section, you cannot hide the negative ones and let visitors assume they are seeing all of them.2 You can still hold back reviews for reasons you apply to every review equally. The rule lists them: reviews containing confidential information, defamatory, harassing, obscene or discriminatory content, the personal information of another person, clearly false content, reviews you reasonably believe are fake, and reviews unrelated to what you offer.2
For a health practice, "the personal information or likeness of another individual" is the exception you will use most. Write the moderation policy down before you need it, and apply it to five-star reviews as strictly as to one-star ones.
Hand-picked quotes on a service page are testimonials, covered in testimonials and social proof.
Can a practice respond to a negative review?
Yes. The FTC says you can respond publicly and "you should watch what you say": the rule prohibits accusing the reviewer of something you know is false, or saying it with reckless disregard for whether it is true.3 For a practice there is a second limit, which comes from HIPAA rather than the FTC. A reply that confirms the reviewer was a patient, or mentions their treatment, can be an impermissible disclosure of health information. How to answer without that is in responding to reviews without breaking HIPAA.
A review request that passes every check
- Send the same request to every patient after the visit, by the same channel, with no survey step in front of it.
- Use neutral wording: "How was your visit? We would value a review on Google."
- Offer nothing in exchange. If you want to thank people, thank everyone, whether or not they post.
- Tell staff in writing not to review the practice, and not to ask family to.
- Reply to criticism with facts about your process, never about the patient.
If you want these checked across your site, your Google Business Profile and your follow-up messages, that is part of a technical and compliance rebuild. This post explains the rule as published. It is not legal advice, and a practice with a specific dispute should speak to a lawyer.