PRINTER'S NO. 1729 THE GENERAL ASSEMBLY OF PENNSYLVANIA HOUSE BILL No.1469 Session of 2025 INTRODUCED BY KHAN, ROWE, SANCHEZ, TOMLINSON, PROKOPIAK, LEADBETER, PIELLI, HILL-EVANS, BURGOS, CEPEDA-FREYTIZ, SHUSTERMAN, SMITH-WADE-EL, WARREN, CIRESI, FLEMING, OTTEN, O'MARA, CERRATO, GREEN, STEELE, HOHENSTEIN, KENYATTA, HOWARD, MAYES, HANBIDGE, GIRAL, LABS, GUENST, INGLIS, COOPER, PUGH, KOZAK AND HAMM, MAY 14, 2025 REFERRED TO COMMITTEE ON HEALTH, MAY 15, 2025 AN ACT Amending the act of July 19, 1979 (P.L.130, No.48), entitled "An act relating to health care; prescribing the powers and duties of the Department of Health; establishing and providing the powers and duties of the State Health Coordinating Council, health systems agencies and Health Care Policy Board in the Department of Health, and State Health Facility Hearing Board in the Department of Justice; providing for certification of need of health care providers and prescribing penalties," providing for hospital price transparency and for prohibition on collection action of debt against patients for noncompliant hospitals . The General Assembly of the Commonwealth of Pennsylvania hereby enacts as follows: Section 1. The act of July 19, 1979 (P.L.130, No.48), known as the Health Care Facilities Act, is amended by adding chapters to read: CHAPTER 8-D HOSPITAL PRICE TRANSPARENCY Section 801-D. Purpose. The purpose of this chapter is to require hospitals to 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 disclose prices for certain items and services provided by hospitals and to provide for enforcement by the department. Section 802-D. Definitions. The following words and phrases when used in this chapter shall have the meanings given to them in this section unless the context clearly indicates otherwise: "Ancillary service." A hospital item or service that a hospital customarily provides as part of a shoppable service. "Chargemaster." The list of all hospital items or services maintained by a hospital for which the hospital has established a charge. "CMS." The Centers for Medicare and Medicaid Services. "De-identified maximum negotiated charge." The highest charge that a hospital has negotiated with all third-party payors for a hospital item or service. "De-identified minimum negotiated charge." The lowest charge that a hospital has negotiated with all third-party payors for a hospital item or service. "Discounted cash price." The charge that applies to an individual who pays cash or a cash equivalent for a hospital item or service. "Facility fee." A fee charged or billed by a hospital for outpatient services provided in an off-campus health care facility, regardless of the modality through which the health care service is provided, that is: (1) Intended to compensate the health system or hospital for health care expenses. (2) Separate and distinct from a professional fee. "Gross charge." The charge for a hospital item or service that is reflected on the hospital's chargemaster, absent any 20250HB1469PN1729 - 2 - 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 discount. "Health care facility." As defined in section 802.1. "Health system." As defined in section 809.2. "Hospital." As defined in section 802.1. "Item or service." An item or service, including an individual items or services package, that could be provided by a hospital to a patient in connection with an inpatient admission or an outpatient department visit for which the hospital has established a standard charge, including any of the following: (1) A supply or procedure. (2) Room and board. (3) The use of the hospital or other item, which is generally described as a facility fee. (4) The service of a health care practitioner, which is generally described as a professional fee. (5) Any other item or service for which a hospital has established a standard charge. "Payor-specific negotiated charge." The charge that a hospital has negotiated with a third-party payor for a hospital item or service. "Professional fee." A fee charged by a health care practitioner for medical services. "Readable format." A digital representation of information in a file that can be easily opened, read and comprehended by an individual with average computer skills and imported or read into a computer system for further processing without any additional preparation. "Shoppable service." A service that may be scheduled by an individual in advance. 20250HB1469PN1729 - 3 - 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 "Standard charge." The regular rate established by the hospital for a hospital item or service provided to a specific group of paying patients reported in United States dollar amounts. The term includes any of the following: (1) The gross charge. (2) The payor-specific negotiated charge. (3) The de-identified minimum negotiated charge. (4) The de-identified maximum negotiated charge. (5) The discounted cash price. "Third-party payor." An entity that is legally responsible for payment of a claim for a hospital item or service. Section 803-D. Public availability of price information required. A hospital shall publish all of the following on its publicly accessible Internet website and provide hard copies upon request: (1) A digital file in a readable format and printable format that contains a list of all standard charges for all hospital items or services as specified under section 804-D. (2) A consumer-friendly and printable list of standard charges for a limited set of shoppable services as provided for under section 805-D. Section 804-D. List of standard charges. (a) List.--A hospital shall have the following duties: (1) Maintain a list of all standard charges for all hospital items or services in accordance with this chapter. (2) Ensure that the list is always available to the public, including publishing the list electronically in the manner specified under section 803-D. (b) Standard charges.--The standard charges contained in the 20250HB1469PN1729 - 4 - 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 list under subsection (a) shall reflect the standard charges applicable to the location of the hospital, regardless of whether the hospital operates in more than one location or operates under the same license as another hospital. (c) Contents.--A hospital shall include all of the following information in the list under subsection (a): (1) A description of each hospital item or service provided by the hospital. (2) The following charges for each individual hospital item or service when provided in either an inpatient setting or an outpatient department setting, as applicable, including: (i) The gross charge. (ii) The de-identified minimum negotiated charge. (iii) The de-identified maximum negotiated charge. (iv) The discounted cash price. (v) The payor-specific negotiated charge, delineated by the name of the third-party payor and plan associated with the charge and displayed in a manner that clearly associates the charge with the third-party payor and plan. A hospital must include all payors and all plans accepted by the hospital in a manner clearly associated with the name of the third-party payor and specific plan. (vi) A code used by the hospital for the purpose of accounting or billing for the hospital item or service, including the Current Procedural Terminology code, the Healthcare Common Procedure Coding System code, the Diagnosis Related Group code, the National Drug Code or other common identifier. (d) Format.--A hospital shall publish the information 20250HB1469PN1729 - 5 - 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 contained in the list under subsection (a) in a single digital file that is in a readable format. (e) Display.--A hospital shall display the list under subsection (a) by posting the list in a prominent location on the home page of the hospital's publicly accessible Internet website or making the list accessible by a dedicated link that is prominently displayed on the home page of the hospital's publicly accessible Internet website. If the hospital operates multiple locations and maintains a single Internet website, the hospital shall post the list for each location that the hospital operates in a manner that clearly associates the list with the applicable location of the hospital and includes charges specific to each individual hospital location. (f) Availability.-- (1) A hospital shall ensure that the list under subsection (a) complies with the following requirements: (i) Be available free of charge. (ii) Be accessible to a common commercial operator of an Internet search engine to the extent necessary for the search engine to index the list and display the list in response to a search query of a user of the search engine. (iii) Be formatted in a manner specified under this chapter and by the department via notice submitted to the Legislative Reference Bureau for publication in the next available issue of the Pennsylvania Bulletin. (iv) Be digitally searchable and printable by service description, billing code and third-party payor. (v) Use a format and a naming convention specified by the department via notice submitted to the Legislative 20250HB1469PN1729 - 6 - 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 Reference Bureau for publication in the next available issue of the Pennsylvania Bulletin. The department shall consider a naming convention as may be specified by CMS. (2) The department shall ensure the list under subsection (a) does not require any of the following: (i) The establishment of a user account or password or other information of the user. (ii) The submission of personal identifying information. (iii) Any other impediment, including entering a code to access the list. (g) Template.--In determining the format of the list under subsection (a) as required under subsection (f)(1), the department shall develop a template that each hospital shall use in formatting the list and publish the template via notice submitted to the Legislative Reference Bureau for publication in the next available issue of the Pennsylvania Bulletin. In developing the template as required under this subsection, the department shall have the following duties: (1) Take into consideration applicable Federal guidelines for formatting similar lists required by Federal law and ensure that the design of the template enables an individual to compare the charges contained in the lists maintained by each hospital. (2) Design the template to be substantially like the template used by CMS for the purposes specified in this chapter. (h) Updates.--A hospital shall update the list under subsection (a) no less than once each year. The hospital shall clearly indicate the date when the list was most recently 20250HB1469PN1729 - 7 - 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 updated, either on the list or in a manner that is clearly associated with the list. The hospital shall make available no less than the three most recent versions of the list as required under this chapter. Section 805-D. List of shoppable services. (a) List.-- Except as provided under subsection (c), a hospital shall maintain and make publicly available a list of the standard charges for each of at least 300 shoppable services provided by the hospital with charges specific to that individual hospital location. The hospital may select the shoppable services to be included in the list, except that the list shall include the 70 services specified as shoppable services by CMS. If the hospital does not provide all the shoppable services specified by CMS, the hospital shall include all the shoppable services provided by the hospital. (b) Selection.--In selecting a shoppable service for the purpose of inclusion in the list under subsection (a), a hospital shall have following duties: (1) Consider how frequently the hospital provides the service and the hospital's billing rate for the service. (2) Prioritize the selection of services that are among the services most frequently provided by the hospital. (c) Exception.--If a hospital does not provide 300 shoppable services in the list under subsection (a), the hospital shall include the total number of shoppable services that the hospital provides in a manner that otherwise complies with the requirements of subsection (a). (d) Contents.--A hospital shall include all of the following information in the list under subsection (a): (1) A plain-language description of each shoppable 20250HB1469PN1729 - 8 - 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 service included on the list. (2) The payor-specific negotiated charge that applies to each shoppable service included on the list and any ancillary service, delineated by the name of the third-party payor and plan associated with the charge and displayed in a manner that clearly associates the charge with the third-party payor and plan. (3) The discounted cash price that applies to each shoppable service included on the list and any ancillary service or, if the hospital does not offer a discounted cash price for a shoppable service or an ancillary service on the list, the gross charge for the shoppable service or ancillary service, as applicable. (4) The de-identified minimum negotiated charge that applies to each shoppable service included on the list and any ancillary service. (5) The de-identified maximum negotiated charge that applies to each shoppable service included on the list and any ancillary service. (6) A code used by the hospital for purposes of accounting or billing for each shoppable service included on the list and any ancillary service, including the Current Procedural Terminology code, the Healthcare Common Procedure Coding System code, the Diagnosis Related Group code, the National Drug Code or other common identifier. (7) If applicable, each location where the hospital provides a shoppable service and whether the standard charges included in the list apply at the location to the provision of the shoppable service in an inpatient setting or an outpatient department setting. 20250HB1469PN1729 - 9 - 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 (8) If applicable, an indication if a shoppable service specified by CMS is not provided by the hospital. (e) Availability.-- (1) A hospital shall ensure that the list under subsection (a) complies with the following requirements: (i) Be available free of charge. (ii) Be accessible to a common commercial operator of an Internet search engine to the extent necessary for the search engine to index the list and display the list in response to a search query of a user of the search engine. (iii) Be formatted in a manner specified under this chapter and by the department via notice submitted to the Legislative Reference Bureau for publication in the next available issue of the Pennsylvania Bulletin. (iv) Be digitally searchable and printable by service description, billing code and third-party payor. (v) Use a format and a naming convention specified by the department via notice submitted to the Legislative Reference Bureau for publication in the next available issue of the Pennsylvania Bulletin. The department shall consider a naming convention as may be specified by CMS. (vi) Nothing in this section shall preclude a hospital from using a price estimator tool as provided for in 45 CFR 180.60 (relating to requirements for displaying shoppable services in a consumer-friendly manner) in addition to the list of shoppable services. (2) The department shall ensure that the list under subsection (a) does not require any of the following: (i) The establishment of a user account or password 20250HB1469PN1729 - 10 - 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 or other information of the user. (ii) The submission of personal identifying information. (iii) Any other impediment, including entering a code to access the list. (f) Template.--In determining the format of the list under subsection (a) as required under subsection (e)(1), the department shall develop a template that each hospital shall use in formatting the list and transmit the template via notice to the Legislative Reference Bureau for publication in the next available issue of the Pennsylvania Bulletin. In developing the template as required under this subsection, the department shall have the following duties: (1) Take into consideration applicable Federal guidelines for formatting similar lists required by Federal law and ensure that the design of the template enables an individual to compare the charges contained in the lists maintained by each hospital. (2) Design the template to be substantially like the template used by CMS for the purposes specified in this chapter. (g) Updates.--A hospital shall update the list under subsection (a) no less than once each year. The hospital shall clearly indicate the date when the list was most recently updated, either on the list or in a manner that is clearly associated with the list. The hospital shall make available no less than the three most recent versions of the list as required under this chapter. Section 806-D. Reporting requirements. (a) Frequency.--Each time a hospital creates or updates a 20250HB1469PN1729 - 11 - 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 list as required under section 804-D or 805-D , the hospital shall submit the list, along with a report on the list, to the department. The department shall determine the form of the report via notice submitted to the Legislation Reference Bureau for publication in the next available issue of the Pennsylvania Bulleti n. (b) Complete data.--To be considered in compliance, any list received by the department shall include a minimum of 95% of all values required under section 804-D or 805-D and shall indicate where values are not applicable according to the determined form and format of the department. (c) Annual report.--By July 1 of each year, a hospital shall report to the department on facility fees charged or billed during the preceding calendar year. The department shall determine the form of the report and transmit notice to the Legislative Reference Bureau for publication in the next available issue of the Pennsylvania Bulletin. The report shall include, at a minimum: (1) The name and location of each health care facility owned or operated by the hospital that provides services for which a facility fee is charged or billed. (2) The number of patient visits at each health care facility for which a facility fee was charged or billed. (3) The number, total amount and types of allowable facility fees paid at each health care facility by Medicare, Medical Assistance and private insurance. (4) For each health care facility, the total number of facility fees charged and the total amount of revenue received by the hospital or health system derived from facility fees. 20250HB1469PN1729 - 12 - 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 (5) The total amount of facility fees charged and the total amount of revenue received by the hospital or health system from all health care facilities derived from facility fees. (6) The 10 most frequent procedures or services, identified by Current Procedural Terminology Category I codes, provided by the hospital that generated the largest amount of facility fee gross revenue, including: (i) The volume of each procedure or service. (ii) The gross and net revenue totals for each procedure or service. (iii) The total net amount of revenue received by the hospital or health system derived from facility fees for each procedure or service. (7) The 10 most frequent procedures or services, identified by Current Procedural Terminology Category I codes, based on patient volume, provided by the hospital for which facility fees were billed or charged, including the gross and net revenue totals received for each procedure or service. (8) Any other information related to facility fees the department may require. (d) Attestation.--An authorized executive of a hospital or health system shall attest, subject to 18 Pa.C.S. § 4904 (relating to unsworn falsification to authorities), that any report or list submitted to the department is complete and accurate to the best of the authorized executive's knowledge and belief. (e) Public availability.--The department shall make all reports and lists available on its publicly accessible Internet 20250HB1469PN1729 - 13 - 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 website within 60 days of receipt of each report. (f) Applicability.--A health system may make the report for each hospital that it owns or operates, provided that each hospital has its own separate report. Section 807-D. Submission of complaints. The department shall establish an electronic form for individuals to submit complaints for alleged violations of this chapter. The department shall post the electronic form on its publicly accessible Internet website. The department shall also accept complaints via a department customer service telephone number. Section 808-D . Plans of correction. Upon determining that a hospital has violated the provisions of this chapter or the regulations promulgated under section 813-D , the department may issue a written notice to the hospital stating that a violation has been committed by the hospital. The following shall apply: (1) The department shall state in the written notice that the hospital is required to take immediate action to remedy the violation or, if the hospital is unable to immediately remedy the violation, submit a plan of correction to the department. (2) If the hospital is required to submit a plan of correction to the department under paragraph (1), the department may direct that the violation be remedied within a specified period of time. The hospital must submit the plan of correction within 30 days of the department's issuance of the written notice. (3) If the department determines that the hospital is required to take immediate corrective action, the department 20250HB1469PN1729 - 14 - 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 shall state in the written notice that the hospital is required to provide prompt confirmation to the department that the corrective action has been taken. Section 809-D. Sanctions and penalties. (a) Grounds for sanctions.--The department may sanction a hospital for any of the following reasons: (1) Violating the provisions of this chapter or the regulations promulgated under section 813-D. (2) Failing to take immediate action to remedy a violation of the provisions of this chapter or regulations promulgated under section 813-D. (3) Failing to submit a plan of correction to the department or failing to comply with a plan of correction in accordance with section 808-D . (4) Violating an order previously issued by the department in a disciplinary matter. (5) Any other reason specified in this chapter or the regulations promulgated by the department under section 813-D as necessary to implement this chapter. (b) Civil penalties.--The department may impose a civil penalty for conduct prohibited under subsection (a), with each day when a hospital engages in the conduct constituting a separate and distinct incident, as follows: (1) No more than $2,500 for a first incident. (2) No more than $5,000 for a second incident. (3) No more than $10,000 for a third incident. (4) No more than $15,000 for a fourth or subsequent incident. (c) Ineligibility.--A hospital that is sanctioned under subsection (a) for a third or subsequent offense shall be 20250HB1469PN1729 - 15 - 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 ineligible to receive a payment from the uncompensated care payment program under Chapter 11 of the act of June 26, 2001 (P.L.755, No.77), known as the Tobacco Settlement Act, for the fiscal year following the third or subsequent offense. (d) Audits.--The department may audit the publicly accessible Internet websites of hospitals to ensure compliance with this chapter. (e) General government appropriations.--Money received from civil penalties imposed by the department on a hospital shall be paid into the General Fund. (f) Administrative proceedings.--The department shall hold hearings and issue adjudications for proceedings conducted under this chapter in accordance with 2 Pa.C.S. (relating to administrative law and procedure) and shall conduct the proceedings in accordance with 1 Pa. Code Pt. II (relating to general rules of administrative practice and procedure). (g) Judicial appeals.--Department adjudications issued under this chapter may be appealed to Commonwealth Court under 42 Pa.C.S. § 763 (relating to direct appeals from government agencies). Section 810-D. Readable format requirements. For purposes of this chapter, the following shall apply to a hospital providing digital files in a readable format: (1) The hospital shall format the file without additional rows or spacing between data. (2) The file shall be readily usable without any additional instructions. (3) The file shall be in a readable format that is widely used by other hospitals for cross-comparison purposes. Section 811-D. Disclosure of facility fees. 20250HB1469PN1729 - 16 - 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 (a) Notice.--A health care facility affiliated with or owned by a hospital that charges a facility fee shall disclose to a patient at the time an appointment is scheduled, and at the time medical services are rendered, that a facility fee may be charged. (b) Disclosure.--Disclosure of facility fees shall occur on a plain language notice as determined by the department. The department shall transmit the notice to the Legislative Reference Bureau for publication in the next available issue of the Pennsylvania Bulletin. The notice shall include, at a minimum: (1) The dollar amount of the patient's potential financial liability for a facility fee if a diagnosis and extent of medical treatment is known. (2) An estimated range in dollars of the patient's potential financial liability for a facility fee if the diagnosis and extent of medical treatment is unknown. (3) If applicable, a statement that the patient may incur a financial liability to the health care facility that the patient would not incur if the patient was receiving medical services and treatment on the campus of the hospital. Section 812-D . Reports. The department shall report annually on the progress in implementing and administering this chapter and submit the report to: (1) The chairperson and minority chairperson of the Appropriations Committee of the Senate. (2) The chairperson and minority chairperson of the Appropriations Committee of the House of Representatives. (3) The chairperson and minority chairperson of the 20250HB1469PN1729 - 17 - 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 Health and Human Services Committee of the Senate. (4) The chairperson and minority chairperson of the Health Committee of the House of Representatives. (5) The chairperson and minority chairperson of the Human Services Committee of the House of Representatives. Section 813-D . Regulations. (a) Temporary regulations.--In order to facilitate the prompt implementation of this chapter, regulations promulgated by the department shall be deemed temporary regulations that shall expire no later than two years following publication. Temporary regulations promulgated under this subsection shall not be subject to: (1) Section 612 of the act of April 9, 1929 (P.L.177, No.175), known as The Administrative Code of 1929. (2) Sections 201, 202, 203, 204 and 205 of the act of July 31, 1968 (P.L.769, No.240), referred to as the Commonwealth Documents Law. (3) Sections 204(b) and 301(10) of the act of October 15, 1980 (P.L.950, No.164), known as the Commonwealth Attorneys Act. (4) The act of June 25, 1982 (P.L.633, No.181), known as the Regulatory Review Act. (b) Expiration.--The department's authority to adopt temporary regulations under subsection (a) shall expire two years after the effective date of this subsection. Regulations adopted after this period shall be promulgated as provided by law. (c) Publication.--The department shall begin submitting the temporary regulations to the Legislative Reference Bureau for publication in the next available issue of the Pennsylvania 20250HB1469PN1729 - 18 - 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 Bulletin no later than six months after the effective date of this subsection. (d) Regulations.--The department shall promulgate regulations as provided by law prior to the expiration of the temporary regulations as necessary to implement this chapter. CHAPTER 8-E PROHIBITION ON COLLECTION ACTION OF DEBT AGAINST PATIENTS FOR NONCOMPLIANT HOSPITALS Section 801-E. Purpose. The purpose of this chapter is to provide for the prohibition on collection action of debt for noncompliant hospitals. Section 802-E. Definitions. The following words and phrases when used in this chapter shall have the meanings given to them in this section unless the context clearly indicates otherwise: "Collection action." Any of the following actions taken with respect to a debt for an item or service that was purchased from or provided to a patient by a hospital on a date during which the hospital was not in material compliance with Chapter 8-D: (1) Attempting to collect a debt from a patient or patient guarantor by referring the debt, directly or indirectly, to a debt collector, a collection agency or other third party retained by or on behalf of the hospital. (2) Suing the patient or patient guarantor or enforcing an arbitration or mediation clause in a hospital document, including any contract, agreement, statement or bill. (3) Directly or indirectly causing a report to be made to a consumer reporting agency. "Collection agency." Any of the following: (1) A person that engages in a business for the 20250HB1469PN1729 - 19 - 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 principal purpose of collecting debts. (2) A person that does any of the following: (i) Regularly collects or attempts to collect, directly or indirectly, debts owed or due or asserted to be owed or due to another. (ii) Takes assignment of debts for collection purposes. (iii) Directly or indirectly solicits for collection debts owed or due or asserted to be owed or due to another. "Consumer reporting agency." A person that, for monetary fees, dues or on a cooperative nonprofit basis, regularly engages, in whole or in part, in the practice of assembling or evaluating consumer credit information or other information on consumers for the purpose of furnishing consumer reports to third parties. The term includes "consumer reporting agency" as defined in 15 U.S.C. § 1681a(f) (relating to definitions; rules of construction). The term does not include a business entity that only provides check verification or check guarantee services. "Debt." An obligation or alleged obligation of a consumer to pay money arising out of a transaction, whether or not the obligation has been reduced to judgment. The term does not include a debt for business, investment, commercial or agricultural purposes or a debt incurred by a business. "Debt collector." A person employed or engaged by a collection agency to perform the collection of debts owed or due, or asserted to be owed or due, to another. "Hospital." As defined in section 802.1. "Item or service." As defined in s ection 802-D. 20250HB1469PN1729 - 20 - 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 Section 803-E. Failure to comply with hospital price transparency. (a) Prohibition.--Except as provided under subsection (d), a hospital that is in violation of the requirements under Chapter 8-D on the date when an item or service is purchased from or provided to a patient by the hospital may not initiate or pursue a collection action against the patient or patient guarantor for a debt owed for the item or service. (b) Civil action.--If a patient believes that a hospital is in violation of the requirements under Chapter 8-D on the date when an item or service is purchased from or provided to the patient and the hospital takes a collection action against the patient or patient guarantor, the patient or patient guarantor may initiate a civil action in a court of competent jurisdiction to determine if the hospital is in violation of Chapter 8-D and the noncompliance is related to the item or service. The hospital may not take a collection action against the patient or patient guarantor or submit a report to a patient's or patient guarantor's credit report while the civil action is pending. (c) Noncompliance.--A hospital that has been determined to be in violation of the requirements under Chapter 8-D shall: (1) refund the payor an amount of the debt the payor has paid and forgive any remaining debt of a payer relative to a violation of the requirements under Chapter 8-D; (2) dismiss or cause to be dismissed a civil action under subsection (b) with prejudice and pay any attorney fees and costs incurred by the patient or patient guarantor relating to the action; and (3) remove or cause to be removed from the patient's or patient guarantor's credit report a report made to a consumer 20250HB1469PN1729 - 21 - 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 reporting agency relating to the debt. (d) Construction.--Nothing in this section shall be construed to: (1) prohibit a hospital from billing a patient, patient guarantor or third-party payor, including a health insurer, for an item or service provided to the patient in a manner that is not in violation of this chapter; or (2) require a hospital to refund a payment made to the hospital for an item or service provided to the patient if no collection action is taken in violation of this chapter. Section 2. This act shall take effect in 180 days. 20250HB1469PN1729 - 22 - 1 2 3 4 5 6 7 8 9 10 11