Us Congress 2023-2024 Regular Session

Us Congress House Bill HB4822

Introduced
7/24/23  
Refer
7/24/23  
Report Pass
7/26/23  

Caption

Health Care Price Transparency Act of 2023

Impact

One critical component of HB4822 is the requirement for hospitals to provide a comprehensive list of their standard charges for items and services. It also introduces limits on cost-sharing for specific Medicare Part D drugs, ensuring that out-of-pocket expenses do not exceed the average net price for those medications. In effect, this bill modifies existing state laws regarding healthcare pricing and patient access to essential cost information. By doing so, it aims to foster a more transparent healthcare environment, where patients are better informed about what they will pay for services and prescriptions.

Summary

House Bill 4822, referred to as the Health Care Price Transparency Act of 2023, seeks to enhance price transparency in healthcare services, particularly focusing on Medicare. The bill mandates healthcare providers, including specific hospitals and pharmacies, to publicly disclose their service charges and drug prices, thus aiming to facilitate better decision-making for patients and reduce the ambiguity around healthcare costs. This is expected to empower patients and lead to more competitive pricing in the healthcare market.

Contention

Notably, this bill has encountered pushback regarding the implications on pharmacy benefit managers (PBMs) and the compliance burden placed on healthcare providers. Critics are concerned that while the intention is to improve transparency, the administrative costs associated with compliance might outweigh the benefits, particularly for smaller providers. Additionally, discussions surrounding the specifics of enforcement provisions and penalties for non-compliance have raised concerns about the potential for increased costs being passed down to patients or providers unable to comply due to resource constraints. The overall discourse emphasizes the balance between transparency and practicality in healthcare pricing.

Companion Bills

US HB2679

Related Pharmacy Benefits Manager Accountability Act

US HB3237

Related To amend title XVIII of the Social Security Act to require each off-campus outpatient department of a provider to include a unique identifier on claims for items and services, and to require providers with a department of a provider to submit to the Centers for Medicare & Medicaid Services an attestation with respect to each such department.

US HB4839

Related Hospital and ASC Price Transparency Act of 2023

US HB4828

Related Imaging Services Price Transparency Act of 2023

US HB4882

Related Clinical Laboratory Price Transparency Act of 2023

US HB4846

Related Better Deals and Lower Prices Act

US HB4881

Related To amend title XVIII of the Social Security Act to limit cost sharing for drugs under the Medicare program.

US HB4883

Related Medicare Common Ownership Transparency Act of 2023

US HB4905

Related Health Insurance Price Transparency Act of 2023

Similar Bills

US HB2679

Pharmacy Benefits Manager Accountability Act

US SB1339

Pharmacy Benefit Manager Reform Act

US HB4839

Hospital and ASC Price Transparency Act of 2023

US HB2691

Transparent PRICE Act Transparent Prices Required to Inform Consumer and Employers Act

US HB410

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.

US SB1130

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

US HB3282

Promoting Transparency and Healthy Competition in Medicare Act

US HB4508

Hidden Fee Disclosure Act