Us Congress 2023-2024 Regular Session

Us Congress House Bill HB410

Introduced
1/20/23  
Refer
1/20/23  

Caption

Health Care Prices Revealed and Information to Consumers Explained Transparency Act or the Health Care PRICE Transparency Act This bill provides statutory authority for requirements for hospitals and health insurance plans to disclose certain information about the costs for items and services. Specifically, hospitals must publish in their list of standard charges certain rates negotiated with insurers, discounts for cash payments, and billing codes. Further, hospitals generally must publish the standard charges for the services provided by the hospital that may be scheduled in advance. Additionally, insurance plans must publish the in-network and out-of-network charges for covered items and services and the negotiated prices for covered prescription drugs. Plans must provide a tool for consumers to search for this cost information. Consumers also may request additional information about the costs of specific items or services under their plans.

Impact

The enactment of HB 410 is expected to have significant implications for hospital pricing and consumer access to financial information regarding healthcare services. By ensuring that consumers can access clear and comprehensive pricing data, the bill aims to promote competition among hospitals and insurers, potentially leading to lower healthcare costs for individuals. Additionally, transparency requirements are intended to simplify the process for consumers to estimate their financial liability for healthcare services, thereby reducing billing disputes and confusion at the point of service.

Summary

House Bill 410, formally known as the Health Care Prices Revealed and Information to Consumers Explained Transparency Act or the Health Care PRICE Transparency Act, aims to enhance transparency in healthcare pricing by establishing requirements for hospitals and health insurers to disclose crucial cost information. The bill mandates that hospitals publish lists of standard charges for various items and services, which must include negotiated charges with insurers, discounts for cash payments, and billing codes in a format that is accessible and easy to understand for consumers. This information is to be made available both online and in paper form upon request, empowering consumers to make informed decisions about their healthcare expenses.

Contention

While proponents of the bill argue that it will enhance consumer protections and encourage cost-effective healthcare choices, there may be concerns regarding the compliance burden on hospitals, particularly smaller facilities that may struggle to meet the new disclosure requirements. Critics highlight that the complexity of healthcare pricing and variations in insurance plans means that even with transparency, consumers may still find it challenging to navigate actual costs. Additionally, enforcement mechanisms stipulated within the bill, including civil penalties for non-compliance, could lead to financial strain for some healthcare providers, raising questions about the balance between consumer protection and operational feasibility.

Companion Bills

US SB1130

Identical bill Health Care PRICE Transparency Act Health Care Prices Revealed and Information to Consumers Explained Transparency Act

US SB2840

Related bill Bipartisan Primary Care and Health Workforce Act

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