Us Congress 2025-2026 Regular Session

Us Congress House Bill HB267 Compare Versions

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Old	New	Differences
1	1	I
2	2	119THCONGRESS
3	3	1
4	4	STSESSION H. R. 267
5	5	To amend the Public Health Service Act to provide for hospital and insurer
6	6	price transparency.
7	7	IN THE HOUSE OF REPRESENTATIVES
8	8	JANUARY9, 2025
9	9	Mr. D
10	10	AVIDSONintroduced the following bill; which was referred to the
11	11	Committee on Energy and Commerce
12	12	A BILL
13	13	To amend the Public Health Service Act to provide for
14	14	hospital and insurer price transparency.
15	15	Be it enacted by the Senate and House of Representa-1
16	16	tives of the United States of America in Congress assembled, 2
17	17	SECTION 1. SHORT TITLE. 3
18	18	This Act may be cited as the ‘‘Health Care Prices 4
19	19	Revealed and Information to Consumers Explained Trans-5
20	20	parency Act’’ or the ‘‘Health Care PRICE Transparency 6
21	21	Act’’. 7
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25	25	SEC. 2. PRICE TRANSPARENCY REQUIREMENTS. 1
26	26	(a) H
27	27	OSPITALS.—Section 2718(e) of the Public 2
28	28	Health Service Act (42 U.S.C. 300gg–18(e)) is amend-3
29	29	ed— 4
30	30	(1) by striking ‘‘Each hospital’’ and inserting 5
31	31	the following: 6
32	32	‘‘(1) I
33	33	N GENERAL.—Each hospital’’; 7
34	34	(2) by inserting ‘‘, in plain language without 8
35	35	subscription and free of charge, in a consumer- 9
36	36	friendly, machine-readable format,’’ after ‘‘a list’’; 10
37	37	and 11
38	38	(3) by adding at the end the following: ‘‘Each 12
39	39	hospital shall include in its list of standard charges, 13
40	40	along with such additional information as the Sec-14
41	41	retary may require with respect to such charges for 15
42	42	purposes of promoting public awareness of hospital 16
43	43	pricing in advance of receiving a hospital item or 17
44	44	service, as applicable, the following: 18
45	45	‘‘(A) A description of each item or service 19
46	46	provided by the hospital. 20
47	47	‘‘(B) The gross charge. 21
48	48	‘‘(C) Any payer-specific negotiated charge 22
49	49	clearly associated with the name of the third 23
50	50	party payer and plan. 24
51	51	‘‘(D) The de-identified minimum nego-25
52	52	tiated charge. 26
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56	56	‘‘(E) The de-identified maximum nego-1
57	57	tiated charge. 2
58	58	‘‘(F) The discounted cash price. 3
59	59	‘‘(G) Any code used by the hospital for 4
60	60	purposes of accounting or billing, including 5
61	61	Current Procedural Terminology (CPT) code, 6
62	62	the Healthcare Common Procedure Coding Sys-7
63	63	tem (HCPCS) code, the Diagnosis Related 8
64	64	Group (DRG), the National Drug Code (NDC), 9
65	65	or other common payer identifier. 10
66	66	‘‘(2) D
67	67	ELIVERY METHODS AND USE .— 11
68	68	‘‘(A) I
69	69	N GENERAL.—Each hospital shall 12
70	70	make public the standard charges described in 13
71	71	paragraph (1) for as many of the 70 Centers 14
72	72	for Medicaid & Medicare Services-specified 15
73	73	shoppable services that are provided by the hos-16
74	74	pital, and as many additional hospital-selected 17
75	75	shoppable services as may be necessary for a 18
76	76	combined total of at least 300 shoppable serv-19
77	77	ices, including the rate at which a hospital pro-20
78	78	vides and bills for that shoppable service. If a 21
79	79	hospital does not provide 300 shoppable services 22
80	80	in accordance with the previous sentence, the 23
81	81	hospital shall make public the information spec-24
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85	85	ified under paragraph (1) for as many 1
86	86	shoppable services as it provides. 2
87	87	‘‘(B) D
88	88	ETERMINATION BY CMS .—A hos-3
89	89	pital shall be deemed by the Centers for Medi-4
90	90	care & Medicaid Services to meet the require-5
91	91	ments of subparagraph (A) if the hospital main-6
92	92	tains an internet-based price estimator tool that 7
93	93	meets the following requirements: 8
94	94	‘‘(i) The tool provides estimates for as 9
95	95	many of the 70 specified shoppable services 10
96	96	that are provided by the hospital, and as 11
97	97	many additional hospital-selected 12
98	98	shoppable services as may be necessary for 13
99	99	a combined total of at least 300 shoppable 14
100	100	services. 15
101	101	‘‘(ii) The tool allows health care con-16
102	102	sumers to, at the time they use the tool, 17
103	103	obtain an estimate of the amount they will 18
104	104	be obligated to pay the hospital for the 19
105	105	shoppable service. 20
106	106	‘‘(iii) The tool is prominently dis-21
107	107	played on the hospital’s website and easily 22
108	108	accessible to the public, without subscrip-23
109	109	tion, fee, or having to submit personal 24
110	110	identifying information (PII), and search-25
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114	114	able by service description, billing code, 1
115	115	and payer. 2
116	116	‘‘(3) D
117	117	EFINITIONS.—Notwithstanding any other 3
118	118	provision of law, for the purpose of paragraphs (1) 4
119	119	and (2): 5
120	120	‘‘(A) D
121	121	E-IDENTIFIED MAXIMUM NEGO -6
122	122	TIATED CHARGE.—The term ‘de-identified max-7
123	123	imum negotiated charge’ means the highest 8
124	124	charge that a hospital has negotiated with all 9
125	125	third party payers for an item or service. 10
126	126	‘‘(B) D
127	127	E-IDENTIFIED MINIMUM NEGO -11
128	128	TIATED CHARGE.—The term ‘de-identified min-12
129	129	imum negotiated charge’ means the lowest 13
130	130	charge that a hospital has negotiated with all 14
131	131	third party payers for an item or service. 15
132	132	‘‘(C) D
133	133	ISCOUNTED CASH PRICE .—The 16
134	134	term ‘discounted cash price’ means the charge 17
135	135	that applies to an individual who pays cash, or 18
136	136	cash equivalent, for a hospital item or service. 19
137	137	Hospitals that do not offer self-pay discounts 20
138	138	may display the hospital’s undiscounted gross 21
139	139	charges as found in the hospital chargemaster. 22
140	140	‘‘(D) G
141	141	ROSS CHARGE.—The term ‘gross 23
142	142	charge’ means the charge for an individual item 24
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146	146	or service that is reflected on a hospital’s 1
147	147	chargemaster, absent any discounts. 2
148	148	‘‘(E) P
149	149	AYER-SPECIFIC NEGOTIATED 3
150	150	CHARGE.—The term ‘payer-specific negotiated 4
151	151	charge’ means the charge that a hospital has 5
152	152	negotiated with a third party payer for an item 6
153	153	or service. 7
154	154	‘‘(F) S
155	155	HOPPABLE SERVICE .—The term 8
156	156	‘shoppable service’ means a service that can be 9
157	157	scheduled by a health care consumer in ad-10
158	158	vance. 11
159	159	‘‘(G) S
160	160	TANDARD CHARGES .—The term 12
161	161	‘standard charges’ means the regular rate es-13
162	162	tablished by the hospital for an item or service, 14
163	163	including both individual items and services and 15
164	164	service packages, provided to a specific group of 16
165	165	paying patients, including the gross charge, the 17
166	166	payer-specific negotiated charge, the discounted 18
167	167	cash price, the de-identified minimum nego-19
168	168	tiated charge, the de-identified maximum nego-20
169	169	tiated charge, and other rates determined by 21
170	170	the Secretary. 22
171	171	‘‘(H) T
172	172	HIRD PARTY PAYER .—The term 23
173	173	‘third party payer’ means an entity that is, by 24
174	174	statute, contract, or agreement, legally respon-25
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178	178	sible for payment of a claim for a health care 1
179	179	item or service. 2
180	180	‘‘(4) E
181	181	NFORCEMENT.—In addition to any other 3
182	182	enforcement actions or penalties that may apply 4
183	183	under subsection (b)(3) or another provision of law, 5
184	184	a hospital that fails to provide the information re-6
185	185	quired by this subsection and has not completed a 7
186	186	corrective action plan to comply with the require-8
187	187	ments of such subsection shall be subject to a civil 9
188	188	monetary penalty of an amount not to exceed $300 10
189	189	per day that the violation is ongoing as determined 11
190	190	by the Secretary. Such penalty shall be imposed and 12
191	191	collected in the same manner as civil money pen-13
192	192	alties under subsection (a) of section 1128A of the 14
193	193	Social Security Act are imposed and collected.’’. 15
194	194	(b) T
195	195	RANSPARENCY IN COVERAGE.—Section 16
196	196	1311(e)(3) of the Patient Protection and Affordable Care 17
197	197	Act (42 U.S.C. 18031(e)(3)) is amended— 18
198	198	(1) in subparagraph (A)— 19
199	199	(A) by redesignating clause (ix) as clause 20
200	200	(xii); and 21
201	201	(B) by inserting after clause (viii), the fol-22
202	202	lowing: 23
203	203	‘‘(ix) In-network provider rates for 24
204	204	covered items and services. 25
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208	208	‘‘(x) Out-of-network allowed amounts 1
209	209	and billed charges for covered items and 2
210	210	services. 3
211	211	‘‘(xi) Negotiated rates and historical 4
212	212	net prices for covered prescription drugs.’’; 5
213	213	(2) in subparagraph (B)— 6
214	214	(A) in the heading, by striking ‘‘
215	215	USE’’ and 7
216	216	inserting ‘‘
217	217	DELIVERY METHODS AND USE ’’; 8
218	218	(B) by inserting ‘‘and subparagraph (C)’’ 9
219	219	after ‘‘subparagraph (A)’’; 10
220	220	(C) by inserting ‘‘, as applicable,’’ after 11
221	221	‘‘English proficiency’’; and 12
222	222	(D) by inserting after the second sentence, 13
223	223	the following: ‘‘The Secretary shall establish 14
224	224	standards for the methods and formats for dis-15
225	225	closing information to individuals. At a min-16
226	226	imum, these standards shall include the fol-17
227	227	lowing: 18
228	228	‘‘(i) An internet-based self-service tool 19
229	229	to provide information to an individual in 20
230	230	plain language, without subscription and 21
231	231	free of charge, in a machine readable for-22
232	232	mat, through a self-service tool on an 23
233	233	internet website that provides real-time re-24
234	234	sponses based on cost-sharing information 25
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238	238	that is accurate at the time of the request 1
239	239	that allows, at a minimum, users to— 2
240	240	‘‘(I) search for cost-sharing infor-3
241	241	mation for a covered item or service 4
242	242	provided by a specific in-network pro-5
243	243	vider or by all in-network providers; 6
244	244	‘‘(II) search for an out-of-net-7
245	245	work allowed amount, percentage of 8
246	246	billed charges, or other rate that pro-9
247	247	vides a reasonably accurate estimate 10
248	248	of the amount an insurer will pay for 11
249	249	a covered item or service provided by 12
250	250	out-of-network providers; and 13
251	251	‘‘(III) refine and reorder search 14
252	252	results based on geographic proximity 15
253	253	of in-network providers, and the 16
254	254	amount of the individual’s cost-shar-17
255	255	ing liability for the covered item or 18
256	256	service, to the extent the search for 19
257	257	cost-sharing information for covered 20
258	258	items or services returns multiple re-21
259	259	sults. 22
260	260	‘‘(ii) In paper form at the request of 23
261	261	the individual that includes no fewer than 24
262	262	20 providers per request with respect to 25
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266	266	which cost-sharing information for covered 1
267	267	items and services is provided, and dis-2
268	268	closes the applicable provider per-request 3
269	269	limit to the individual, mailed to the indi-4
270	270	vidual not later than 2 business days after 5
271	271	receiving an individual’s request.’’; 6
272	272	(3) in subparagraph (C)— 7
273	273	(A) in the first sentence— 8
274	274	(i) by striking ‘‘The Exchange’’ and 9
275	275	inserting the following: 10
276	276	‘‘(i) I
277	277	N GENERAL.—The Exchange’’; 11
278	278	(ii) by inserting ‘‘or out-of-network 12
279	279	provider’’ after ‘‘item or service by a par-13
280	280	ticipating provider’’; and 14
281	281	(iii) by inserting before the period the 15
282	282	following: ‘‘the following information: 16
283	283	‘‘(i) An estimate of an individual’s 17
284	284	cost-sharing liability for a requested cov-18
285	285	ered item or service furnished by a pro-19
286	286	vider, which shall reflect any cost-sharing 20
287	287	reductions the individual would receive. 21
288	288	‘‘(ii) A description of the accumulated 22
289	289	amounts. 23
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293	293	‘‘(iii) The in-network rate, including 1
294	294	negotiated rates and underlying fee sched-2
295	295	ule rates. 3
296	296	‘‘(iv) The out-of-network allowed 4
297	297	amount or any other rate that provides a 5
298	298	more accurate estimate of an amount an 6
299	299	issuer will pay, including the percent reim-7
300	300	bursed by insurers to out-of-network pro-8
301	301	viders, for the requested covered item or 9
302	302	service furnished by an out-of-network pro-10
303	303	vider. 11
304	304	‘‘(v) A list of the items and services 12
305	305	included in bundled payment arrangements 13
306	306	for which cost-sharing information is being 14
307	307	disclosed. 15
308	308	‘‘(vi) A notification that coverage of a 16
309	309	specific item or service is subject to a pre-17
310	310	requisite, if applicable. 18
311	311	‘‘(vii) A notice that includes the fol-19
312	312	lowing information: 20
313	313	‘‘(I) A statement that out-of-net-21
314	314	work providers may bill individuals for 22
315	315	the difference, including the balance 23
316	316	billing, between a provider’s billed 24
317	317	charges and the sum of the amount 25
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321	321	collected from the insurer in the form 1
322	322	of a copayment or coinsurance 2
323	323	amount and the cost-sharing informa-3
324	324	tion. 4
325	325	‘‘(II) A statement that the actual 5
326	326	charges for an individual’s covered 6
327	327	item or service may be different from 7
328	328	an estimate of cost-sharing liability 8
329	329	depending on the actual items or serv-9
330	330	ices the individual receives at the 10
331	331	point of care. 11
332	332	‘‘(III) A statement that the esti-12
333	333	mate of cost-sharing liability for a 13
334	334	covered item or service is not a guar-14
335	335	antee that benefits will be provided 15
336	336	for that item or service. 16
337	337	‘‘(IV) A statement disclosing 17
338	338	whether the plan counts copayment 18
339	339	assistance and other third-party pay-19
340	340	ments in the calculation of the indi-20
341	341	vidual’s deductible and out-of-pocket 21
342	342	maximum. 22
343	343	‘‘(V) For items and services that 23
344	344	are recommended preventive services 24
345	345	under section 2713 of the Public 25
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349	349	Health Service Act, a statement that 1
350	350	an in-network item or service may not 2
351	351	be subject to cost-sharing if it is billed 3
352	352	as a preventive service in the insurer 4
353	353	cannot determine whether the request 5
354	354	is for a preventive or non-preventive 6
355	355	item or service. 7
356	356	‘‘(VI) Any additional informa-8
357	357	tion, including other disclaimers, that 9
358	358	the insurer determines is appropriate, 10
359	359	provided the additional information 11
360	360	does not conflict with the information 12
361	361	required to be provided by this sub-13
362	362	section.’’; 14
363	363	(B) by striking the second sentence; and 15
364	364	(C) by adding at the end the following: 16
365	365	‘‘(ii) D
366	366	EFINITIONS.—Notwithstanding 17
367	367	any other provision of law, for the purpose 18
368	368	of this subparagraph and subparagraphs 19
369	369	(A) and (B): 20
370	370	‘‘(I) A
371	371	CCUMULATED AMOUNTS .— 21
372	372	The term ‘accumulated amounts’ 22
373	373	means the amount of financial respon-23
374	374	sibility an individual has incurred at 24
375	375	the time a request for cost-sharing in-25
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379	379	formation is made, with respect to a 1
380	380	deductible or out-of-pocket limit, in-2
381	381	cluding any expense that counts to-3
382	382	ward a deductible or out-of-pocket 4
383	383	limit, but exclude any expense that 5
384	384	does not count toward a deductible or 6
385	385	out-of-pocket limit. To the extent an 7
386	386	insurer imposes a cumulative treat-8
387	387	ment limitation on a particular cov-9
388	388	ered item or service independent of in-10
389	389	dividual medical necessity determina-11
390	390	tions, the amount that has accrued to-12
391	391	ward the limit on the item or service. 13
392	392	‘‘(II) H
393	393	ISTORICAL NET PRICE.— 14
394	394	The term ‘historical net price’ means 15
395	395	the retrospective average amount an 16
396	396	insurer paid for a prescription drug, 17
397	397	inclusive of any reasonably allocated 18
398	398	rebates, discounts, chargebacks, fees, 19
399	399	and any additional price concessions 20
400	400	received by the insurer with respect to 21
401	401	the prescription drug. The allocation 22
402	402	shall be determined by dollar value for 23
403	403	non-product specific and product-spe-24
404	404	cific rebates, discounts, chargebacks, 25
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408	408	fees, and other price concessions to 1
409	409	the extent that the total amount of 2
410	410	any such price concession is known to 3
411	411	the insurer at the time of publication 4
412	412	of the historical net price. 5
413	413	‘‘(III) N
414	414	EGOTIATED RATE.—The 6
415	415	term ‘negotiated rate’ means the 7
416	416	amount a plan or issuer has contrac-8
417	417	tually agreed to pay for a covered 9
418	418	item or service, whether directly or in-10
419	419	directly through a third party admin-11
420	420	istrator or pharmacy benefit manager, 12
421	421	to an in-network provider, including 13
422	422	an in-network pharmacy or other pre-14
423	423	scription drug dispenser, for covered 15
424	424	items or services. 16
425	425	‘‘(IV) O
426	426	UT-OF-NETWORK AL -17
427	427	LOWED AMOUNT .—The term ‘out-of- 18
428	428	network allowed amount’ means the 19
429	429	maximum amount an insurer will pay 20
430	430	for a covered item or service furnished 21
431	431	by an out-of-network provider. 22
432	432	‘‘(V) O
433	433	UT-OF-NETWORK LIMIT.— 23
434	434	The term ‘out-of-network limit’ means 24
435	435	the maximum amount that an indi-25
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439	439	vidual is required to pay during a cov-1
440	440	erage period for his or her share of 2
441	441	the costs of covered items and services 3
442	442	under his or her plan or coverage, in-4
443	443	cluding for self-only and other than 5
444	444	self-only coverage, as applicable. 6
445	445	‘‘(VI) U
446	446	NDERLYING FEE SCHED -7
447	447	ULE RATES.—The term ‘underlying 8
448	448	fee schedule rates’ means the rate for 9
449	449	an item or service that a plan or 10
450	450	issuer uses to determine a partici-11
451	451	pant’s, beneficiary’s, or enrollee’s 12
452	452	cost-sharing liability from a particular 13
453	453	provider or providers, when the rate is 14
454	454	different from the negotiated rate.’’; 15
455	455	(4) in subparagraph (D), by striking ‘‘subpara-16
456	456	graph (A)’’ and inserting ‘‘subparagraphs (A), (B), 17
457	457	and (C)’’; and 18
458	458	(5) by adding at the end the following: 19
459	459	‘‘(F) A
460	460	PPLICATION OF PARAGRAPH .—In 20
461	461	addition to qualified health plans (and plans 21
462	462	seeking certification as qualified health plans), 22
463	463	this paragraph (as amended by the Health Care 23
464	464	Prices Revealed and Information to Consumers 24
465	465	Explained Transparency Act) shall apply to 25
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469	469	group health plans (including self-insured and 1
470	470	fully insured plans) and health insurance cov-2
471	471	erage (as such terms are defined in section 3
472	472	2791 of the Public Health Service Act).’’. 4
473	473	Æ
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