2025 STATE OF WYOMING 25LSO-0356 ENGROSSED 1HB0121 HOUSE BILL NO. HB0121 Hospital pricing transparency. Sponsored by: Representative(s) Singh, Andrew, Bear, Haroldson, Harshman, Locke, Neiman and Rodriguez-Williams and Senator(s) Biteman, Hutchings, Laursen, D, Rothfuss and Salazar A BILL for 1 AN ACT relating to public health and safety; requiring 2 hospitals to list prices for medical items and services as 3 specified; requiring the department of health to monitor 4 and enforce the provisions of this act; providing 5 penalties; prohibiting collection actions as specified; 6 requiring recommendations for proposed legislation; 7 providing definitions; requiring rulemaking; making 8 conforming amendments; and providing for effective dates. 9 10 11 12. W.S. 35-2-1501 through 35-2-1511 are 13 created to read: 14 2025STATE OF WYOMING25LSO-0356 ENGROSSED 2HB0121 1 ARTICLE 15 2 DISCLOSURE OF HOSPITAL PRICING 3 4 5 6 (a) This act shall be known and may be cited as the 7 "Hospital Price Transparency Act." 8 9 (b) The purpose of this act is to require hospitals 10 to disclose prices for certain items and services, to 11 provide civil penalties and to prohibit debt collection by 12 noncompliant facilities. 13 14 15 16 (a) As used in this act: 17 18 (i) "Ancillary service" means a facility item or 19 service that a facility customarily provides as part of a 20 shoppable service; 21 22 (ii) "Department" means the department of 23 health; 2025STATE OF WYOMING25LSO-0356 ENGROSSED 3HB01211 2 (iii) "De-identified maximum negotiated charge" 3 means the highest charge a facility has negotiated with all 4 third party payors for a facility item or service; 5 6 (iv) "De-identified minimum negotiated charge" 7 means the lowest charge a facility has negotiated with all 8 third party payors for a facility item or service; 9 10 (v) "Discounted cash price" means the charge 11 that applies to a person who pays cash, or a cash 12 equivalent, for a facility item or service; 13 14 (vi) "Facility" means a hospital licensed under 15 title 35 of the Wyoming statutes; 16 17 (vii) "Facility item or service" means all items 18 and services, including individual items and services and 19 service packages, that may be provided by a facility to a 20 patient in connection with an inpatient admission or an 21 outpatient department visit for which the facility has 22 established a standard charge, including: 23 2025STATE OF WYOMING25LSO-0356 ENGROSSED 4HB01211 (A) Supplies and procedures; 2 3 (B) Room and board; 4 5 (C) Use of the facility and other areas, 6 generally referred to as facility fees; 7 8 (D) Services of health care providers 9 employed by the facility, generally referred to as 10 professional charges; 11 12 (E) Any other item or service for which a 13 facility has established a standard charge. 14 15 (viii) "Gross charge" means the charge for a 16 facility item or service that is reflected on a facility's 17 list, less any discounts; 18 19 (ix) "Machine-readable format" means a digital 20 representation of information that can be imported or read 21 into a computer system for processing; 22 2025STATE OF WYOMING25LSO-0356 ENGROSSED 5HB01211 (x) "Payor-specific negotiated charge" means the 2 charge that a facility has negotiated with a third party 3 payor for a facility item or service; 4 5 (xi) "Shoppable service" means a service that 6 may be scheduled by a patient in advance; 7 8 (xii) "Standard charge" means the regular rate 9 established by the facility for a facility item or service 10 provided to a specific group of paying patients. The term 11 includes all of the following: 12 13 (A) The gross charge; 14 15 (B) The payor-specific negotiated charge; 16 17 (C) The de-identified minimum negotiated 18 charge; 19 20 (D) The de-identified maximum negotiated 21 charge; 22 23 (E) The discounted cash price. 2025STATE OF WYOMING25LSO-0356 ENGROSSED 6HB01211 2 (xiii) "Third-party payor" means a person that 3 is, by statute, contract or agreement, legally responsible 4 for payment of a claim for a facility item or service; 5 6 (xiv) "This act" means W.S. 35-2-1501 through 7 35-2-1511. 8 9 10 11 12 (a) Notwithstanding any other law, a facility shall 13 make public: 14 15 (i) A digital file in a machine-readable format 16 that contains a list of all standard charges, expressed in 17 dollar amounts, for all facility items or services as 18 described by W.S. 35-2-1504; 19 20 (ii) A consumer-friendly list of standard 21 charges for a limited set of shoppable services as provided 22 in W.S. 35-2-1505. 23 2025STATE OF WYOMING25LSO-0356 ENGROSSED 7HB01211 2 3 (a) A facility shall: 4 5 (i) Maintain a list of all standard charges for 6 all facility items or services in accordance with this 7 section; and 8 9 (ii) Make the list required under paragraph (i) 10 of this subsection available at all times to the public, 11 including by posting the list in the manner provided by 12 this section. 13 14 (b) The standard charges contained in the list 15 required to be maintained by a facility under subsection 16 (a) of this section shall reflect the standard charges 17 applicable to that location of the facility, regardless of 18 whether the facility operates in more than one (1) location 19 or operates under the same license as another facility. 20 21 (c) The list required under subsection (a) of this 22 section shall include the following items, if applicable: 23 2025STATE OF WYOMING25LSO-0356 ENGROSSED 8HB01211 (i) A description of each facility item or 2 service provided by the facility; 3 4 (ii) The following charges, expressed in dollar 5 amounts, for each individual facility item or service when 6 provided in either an inpatient setting or an outpatient 7 department setting: 8 9 (A) The gross charge; 10 11 (B) The de-identified minimum negotiated 12 charge; 13 14 (C) The de-identified maximum negotiated 15 charge; 16 17 (D) The discounted cash price; 18 19 (E) The payor-specific negotiated charge, 20 listed by the name of the third party payor and plan 21 associated with the charge and displayed in a manner that 22 clearly associates the charge with each third party payor 23 and plan; and 2025STATE OF WYOMING25LSO-0356 ENGROSSED 9HB01211 2 (F) Any code used by the facility for 3 purposes of accounting or billing for the facility item or 4 service. 5 6 (d) The list required by subsection (a) of this 7 section shall be displayed in a prominent location on the 8 home page of the facility's publicly accessible website or 9 accessible through a link on that website. If the facility 10 operates multiple locations and maintains a single website, 11 the list shall be posted for each location the facility 12 operates in a manner that clearly associates the list with 13 the applicable location of the facility. 14 15 (e) The list required under subsection (a) of this 16 subsection shall: 17 18 (i) Be available: 19 20 (A) Free of charge; 21 22 (B) Without having to establish a user 23 account or password; 2025STATE OF WYOMING25LSO-0356 ENGROSSED 10HB01211 2 (C) Without having to submit personal 3 identifying information; 4 5 (D) Without having to enter a code to 6 access the list. 7 8 (ii) Be accessible to a common commercial 9 operator of an internet search engine to the extent 10 necessary for the search engine to index and display the 11 list as a result in response to a search query of a user of 12 the search engine; 13 14 (iii) Be formatted in a manner prescribed by the 15 department; 16 17 (iv) Be digitally searchable; 18 19 (v) Use the naming convention specified by the 20 centers for Medicare and Medicaid services. 21 22 (f) In prescribing the format for the list under 23 paragraph (e)(iii) of this section, the department shall: 2025STATE OF WYOMING25LSO-0356 ENGROSSED 11HB01211 2 (i) Develop a template that each facility shall 3 use in formatting the list; 4 5 (ii) Consider any applicable federal guidelines 6 for formatting similar lists required by federal law or 7 rule and ensure that the design of the template enables 8 health care researchers to compare the charges contained in 9 the lists maintained by each facility; and 10 11 (iii) Design the template to be substantially 12 similar to the template used by the centers for Medicare 13 and Medicaid services for purposes similar to those of this 14 act, if the department determines that designing the 15 template in that manner serves the purposes of paragraph 16 (ii) of this subsection and that the department benefits 17 from developing and requiring that substantially similar 18 design. 19 20 (g) Each facility shall update the list required by 21 subsection (a) of this section not less than annually. Each 22 facility shall clearly indicate the date on which the list 23 was updated. 2025STATE OF WYOMING25LSO-0356 ENGROSSED 12HB01211 2 3 4 5 (a) A facility shall maintain and make publicly 6 available a list of the standard charges described by W.S. 7 35-2-1504(c) for not less than three hundred (300) 8 shoppable services provided by the facility. Each facility 9 may select the shoppable services to be included in the 10 list, except that the list shall include: 11 12 (i) The seventy (70) services specified by the 13 centers for Medicare and Medicaid services in 45 C.F.R. 14 part 180; or 15 16 (ii) If the facility does not provide all of the 17 shoppable services described by paragraph (i) of this 18 subsection, as many of those shoppable services as the 19 facility does provide. Services that are not provided but 20 are Medicare and Medicaid listed services shall be 21 identified by the facility; and 22 2025STATE OF WYOMING25LSO-0356 ENGROSSED 13HB01211 (iii) State each location where a facility 2 provides the shoppable service and whether the standard 3 charges included in the list apply at that location to the 4 provision of that shoppable service in an inpatient 5 setting, an outpatient department setting or in both of 6 those settings. 7 8 (b) In selecting a shoppable service for purposes of 9 inclusion in the list required by subsection (a) of this 10 section, a facility shall: 11 12 (i) Consider how frequently the facility 13 provides the services and the facility's billing rate for 14 that service; and 15 16 (ii) Prioritize the selection of services that 17 are among the services most frequently provided by the 18 facility. 19 20 (c) The list required by subsection (a) of this 21 section shall be: 22 2025STATE OF WYOMING25LSO-0356 ENGROSSED 14HB01211 (i) Displayed in a manner prescribed by W.S. 2 35-2-1504(d); 3 4 (ii) Available: 5 6 (A) Free of charge; 7 8 (B) Without having to register or establish 9 a user account or password; 10 11 (C) Without having to submit personal 12 identifying information; and 13 14 (D) Without having to enter a code to 15 access the list. 16 17 (iii) Searchable by service description, billing 18 code and third party payor; 19 20 (iv) Updated in the manner prescribed by W.S. 21 35-2-1504(g); 22 2025STATE OF WYOMING25LSO-0356 ENGROSSED 15HB01211 (v) Accessible to a common commercial operation 2 of an internet search engine to the extent necessary for 3 the search engine to index and display the list as a result 4 in response to a search query of a user of the search 5 engine; and 6 7 (vi) Formatted in a manner that is consistent 8 with the format prescribed by the department under W.S. 9 35-2-1504(e)(iii). 10 11 12 13 Each time a facility updates a list as required by W.S. 14 35-2-1504(g) and 35-2-1505(c)(iv), the facility shall 15 submit the updated list to the department. The department 16 shall prescribe the form in which the updated list shall be 17 submitted to the department. 18 19 20 21 (a) The department shall monitor each facility's 22 compliance with the requirements of this act using any of 23 the following methods: 2025STATE OF WYOMING25LSO-0356 ENGROSSED 16HB0121 1 2 (i) Evaluating complaints made by persons to the 3 department regarding noncompliance with the act; 4 5 (ii) Reviewing any analysis prepared regarding 6 noncompliance with this act; 7 8 (iii) Auditing the websites of facilities for 9 compliance with this act; 10 11 (iv) Confirming that each facility submitted the 12 lists as required by W.S. 35-2-1506. 13 14 (b) Notwithstanding any provision of law to the 15 contrary, in considering an application for renewal of a 16 facility's license or certificate, the department shall 17 consider whether a facility is or has been in compliance 18 with this act. 19 20 21 22 2025STATE OF WYOMING25LSO-0356 ENGROSSED 17HB01211 (a) A facility materially violates this act if the 2 facility fails to: 3 4 (i) Comply with the requirements of W.S. 5 35-2-1503; or 6 7 (ii) Publicize the facility's standard charges 8 in the form and manner required by W.S. 35-2-1504 and 9 35-2-1505. 10 11 (b) If the department determines that a facility has 12 materially violated this act, the department shall issue a 13 material violation notice to the facility and request that 14 the facility submit a corrective action plan within thirty 15 (30) days of receiving the material violation notice. The 16 notice shall indicate the form and manner that the 17 corrective action plan shall be submitted to the department 18 and shall clearly state the date by which the facility 19 shall submit the plan. 20 21 (c) The facility that receives a notice under 22 subsection (b) of this section shall: 23 2025STATE OF WYOMING25LSO-0356 ENGROSSED 18HB01211 (i) Submit a corrective action plan in the form 2 and manner, and by the specified date, prescribed by the 3 notice of violation; and 4 5 (ii) Act to comply with the plan within thirty 6 (30) days of submitting the plan to the department. 7 8 (d) A corrective action plan submitted to the 9 department shall: 10 11 (i) Describe in detail the corrective action the 12 facility will take to address any violation identified by 13 the department in the notice provided under subsection (b) 14 of this section; and 15 16 (ii) Provide a date by which the facility will 17 complete the corrective action plan. 18 19 (e) A corrective action plan is subject to review and 20 approval by the department. After the department reviews 21 and approves a facility's corrective action plan, the 22 department shall monitor and evaluate the facility's 23 compliance with the plan. 2025STATE OF WYOMING25LSO-0356 ENGROSSED 19HB0121 1 2 (f) A facility is considered to have failed to 3 respond to the department's request to submit a corrective 4 action plan if the facility fails to submit a corrective 5 action plan: 6 7 (i) In the form and manner specified in the 8 notice under subsection (b) of this section; or 9 10 (ii) By the date specified in the notice 11 provided in subsection (b) of this section. 12 13 (g) A facility is considered to have failed to comply 14 with a corrective action plan if the facility fails to 15 address a violation within the specified period of time 16 contained in the plan. 17 18 19 20 (a) The department shall impose a civil penalty on a 21 facility if a facility fails to: 22 2025STATE OF WYOMING25LSO-0356 ENGROSSED 20HB01211 (i) Respond to the department's notice to submit 2 a corrective action plan; or 3 4 (ii) Comply with the requirements of a 5 corrective action plan submitted to the department. 6 7 (b) The department shall impose a civil penalty on a 8 facility of: 9 10 (i) For facilities categorized as critical 11 access hospitals: 12 13 (A) For a first offense, one hundred 14 dollars ($100.00) per day for each day a facility fails to 15 comply with subsection (a) of this section; 16 17 (B) For a second offense, five hundred 18 dollars ($500.00) per day for each day a facility fails to 19 comply with subsection (a) of this section; 20 21 (C) For a third or subsequent offense, one 22 thousand dollars ($1,000.00) per day for each day a 2025STATE OF WYOMING25LSO-0356 ENGROSSED 21HB0121 1 facility fails to comply with subsection (a) of this 2 section. 3 4 (ii) For all other facilities, one thousand 5 dollars ($1,000.00) per day for each day a facility fails 6 to comply with subsection (a) of this section. 7 8 (c) Beginning October 1, 2025, the department shall 9 create and maintain a publicly available list on its 10 website of facilities that have been found in violation of 11 this act, that have been issued a civil penalty or sent a 12 warning notice and that have been sent a request for a 13 corrective action plan from the department. Such penalties, 14 notices and communications shall be subject to public 15 disclosure under 5 U.S.C. § 552, notwithstanding any 16 exemptions or exclusions to the contrary, in full without 17 redaction. The list required by this subsection shall be 18 updated every thirty (30) days. 19 20 21 22 The department shall propose to the legislature any 23 necessary recommendations for amending this act, including 2025STATE OF WYOMING25LSO-0356 ENGROSSED 22HB0121 1 recommendations in response to amendments by the centers 2 for Medicare and Medicaid services to 45 C.F.R. Part 180. 3 4 5 6 7 (a) As used in this section: 8 9 (i) "Collection action" means any of the 10 following actions taken with respect to a debt for items 11 and services that were purchased from or provided to a 12 patient by a facility on a date during which the facility 13 was in material noncompliance with this act: 14 15 (A) Attempting to collect a debt from a 16 patient or patient guarantor by referring the debt, 17 directly or indirectly, to a debt collector, a collection 18 agency or a third party payor retained by or on behalf of 19 the facility; 20 21 (B) Suing the patient or patient guarantor, 22 or enforcing an arbitration or mediation agreement; or 23 2025STATE OF WYOMING25LSO-0356 ENGROSSED 23HB01211 (C) Directly or indirectly causing a report 2 to be made to a consumer reporting agency. 3 4 (ii) "Collection agency" means any: 5 6 (A) Person who engages in a business the 7 principal purpose of which is the collection of debts; or 8 9 (B) Person who: 10 11 (I) Regularly collects or attempts to 12 collect, directly or indirectly, debts owed, due or 13 asserted to be owed or due to another; 14 15 (II) Takes assignment of debts for 16 collection purposes; or 17 18 (III) Directly or indirectly solicits 19 for collection debts owed, due or asserted to be owed or 20 due to another. 21 22 (iii) "Consumer reporting agency" means any 23 person who, for monetary fees, dues or on a cooperative 2025STATE OF WYOMING25LSO-0356 ENGROSSED 24HB0121 1 nonprofit basis, regularly engages, in whole or in part, in 2 the practice of assembling or evaluating consumer credit 3 information or other information on consumers for the 4 purpose of furnishing consumer reports to third parties. 5 "Consumer reporting agency" includes any person defined in 6 15 U.S.C. § 1681a(f). "Consumer reporting agency" shall not 7 include any business entity that provides check 8 verification or check guarantee services only; 9 10 (iv) "Debt" means any obligation or alleged 11 obligation of a consumer to pay money arising out of a 12 transaction, whether or not the obligation has been reduced 13 to a judgment. "Debt" shall not include a debt for 14 business, investment, commercial or agricultural purposes; 15 16 (v) "Debt collector" means any person employed 17 or engaged by a collection agency to perform the collection 18 of debts owed, due or asserted to be owed or due to 19 another. 20 21 (b) A facility that is in material noncompliance with 22 this act on the date that items and services are purchased 23 from or provided to a patient by the facility shall not 2025STATE OF WYOMING25LSO-0356 ENGROSSED 25HB0121 1 initiate or pursue a collection action against the patient 2 or patient guarantor for a debt owed for the item or 3 services. 4 5 (c) If a patient provides documentation that a 6 facility was in material noncompliance with this act on a 7 date that items or services were purchased by or provided 8 to the patient, and the facility takes collection action 9 against the patient or patient guarantor, the patient or 10 patient guarantor may file suit to determine if the 11 facility was materially out of compliance with this act on 12 the date of service, and the noncompliance is related to 13 the items and services. The facility shall not take a 14 collection action against the patient or patient guarantor 15 while the lawsuit is pending. 16 17 (d) A facility that has been found by a court of 18 competent jurisdiction to be materially out of compliance 19 with this act: 20 21 (i) Shall refund the payor any amount of the 22 debt the payor has paid and shall pay a penalty to the 2025STATE OF WYOMING25LSO-0356 ENGROSSED 26HB0121 1 patient or patient guarantor in an amount equal to the 2 total amount of the debt; 3 4 (ii) Shall dismiss or cause to be dismissed any 5 court action with prejudice and pay any attorney fees and 6 costs incurred by the patient or patient guarantor relating 7 to the action; and 8 9 (iii)Remove or cause to be removed from the 10 patient or patient guarantor's credit report any report 11 made to a consumer reporting agency relating to the debt. 12 13 (e) Nothing in this section: 14 15 (i) Prohibits a facility from billing a patient, 16 patient guarantor or third party payor for items or 17 services provided to the patient; or 18 19 (ii) Requires a facility to refund any payment 20 made to the facility for items or services provided to the 21 patient, provided no collection action is taken in 22 violation of this section. 23 2025STATE OF WYOMING25LSO-0356 ENGROSSED 27HB01211. W.S. 35‑2‑905(a) by creating a new 2 paragraph (vi) is amended to read: 3 4 5 6 7 (a) The division may place conditions upon a license, 8 install a division approved monitor or manager at the 9 owner's or operator's expense, suspend admissions, or deny, 10 suspend or revoke a license issued under this act if a 11 licensee: 12 13 14 15 16The department of health shall promulgate 17 all rules necessary to implement this act. 18 19 20 2025STATE OF WYOMING25LSO-0356 ENGROSSED 28HB01211 (a) Except as otherwise provided by subsection (b) of 2 this section, this act is effective July 1, 2025. 3 4 (b) Sections 3 and 4 of this act are effective 5 immediately upon completion of all acts necessary for a 6 bill to become law as provided by Article 4, Section 8 of 7 the Wyoming Constitution. 8 9 (END)