Hospital Price Transparency and Disclosure Act

I 116TH CONGRESS 1ST SESSION H. R. 3965 To amend the Public Health Service Act to provide for enhancements to requirements for public disclosure of hospital price data. IN THE HOUSE OF REPRESENTATIVES JULY 25, 2019 Mr. LIPINSKI introduced the following bill; which was referred to the Committee on Energy and Commerce A BILL To amend the Public Health Service Act to provide for enhancements to requirements for public disclosure of hospital price data. Be it enacted by the Senate and House of Representa- 1 tives of the United States of America in Congress assembled, 2 SECTION 1. SHORT TITLE. 3 This Act may be cited as the ‘‘Hospital Price Trans- 4 parency and Disclosure Act’’. 5 SEC. 2. ENHANCING PUBLIC DISCLOSURE OF HOSPITAL 6 PRICE DATA. 7 Section 2718(e) of the Public Health Service Act is 8 amended— 9 VerDate Sep 11 2014 02:07 Aug 06, 2019 Jkt 089200 PO 00000 Frm 00001 Fmt 6652 Sfmt 6201 E:\BILLS\H3965.IH H3965 kjohnson on DSK79L0C42 with BILLS 2 •HR 3965 IH (1) by striking ‘‘CHARGES.—Each hospital’’ 1 and inserting ‘‘CHARGES.— 2 ‘‘(1) IN GENERAL.—Each hospital’’; and 3 (2) by adding at the end the following new 4 paragraphs: 5 ‘‘(2) FORMAT.—The guidelines developed under 6 paragraph (1) shall provide that all standard 7 charges described in paragraph (1) are published in 8 a uniform, machine-readable format. 9 ‘‘(3) PUBLIC POSTING OF DATA.— 10 ‘‘(A) PUBLIC POSTING OF DATA.—The 11 guidelines developed under paragraph (1) shall 12 provide that the standard charges described in 13 paragraph (1) shall be made public by hospitals 14 through a process specified by the Secretary 15 under which the standard charges are sub- 16 mitted by the hospitals to the Secretary and the 17 Secretary promptly posts the standard charges 18 on the official public Internet site of the De- 19 partment of Health and Human Services. Such 20 data shall be set forth in a manner that pro- 21 motes charge comparison among hospitals and 22 in a manner that compares the price data for 23 an item or service submitted by the hospital 24 with the price payable for the same item or 25 VerDate Sep 11 2014 02:07 Aug 06, 2019 Jkt 089200 PO 00000 Frm 00002 Fmt 6652 Sfmt 6201 E:\BILLS\H3965.IH H3965 kjohnson on DSK79L0C42 with BILLS 3 •HR 3965 IH service under title XVIII of the Social Security 1 Act. 2 ‘‘(B) ACCESS.—In carrying out subpara- 3 graph (A), the Secretary shall create applica- 4 tion programming interfaces and take any other 5 necessary steps to facilitate access to data sub- 6 mitted pursuant to paragraph (1) to third par- 7 ties seeking to present such data in a con- 8 sumer-friendly format. 9 ‘‘(C) NOTICE OF AVAILABILITY.—Each 10 hospital required to submit data under this sub- 11 section shall prominently post at each admis- 12 sion site of the hospital a notice of the avail- 13 ability of the data so submitted on the official 14 public Internet site under subparagraph (A). 15 ‘‘(4) CIVIL MONETARY PENALTY.—The Sec- 16 retary may impose a civil monetary penalty of not 17 more than $10,000 for each knowing violation of 18 paragraph (1) or (3)(C) by a hospital. The provi- 19 sions of subsection (i)(2) of section 351A shall apply 20 with respect to civil monetary penalties under this 21 paragraph in the same manner as such provisions 22 apply to civil monetary penalties under subsection 23 (i)(1) of such section. 24 VerDate Sep 11 2014 02:07 Aug 06, 2019 Jkt 089200 PO 00000 Frm 00003 Fmt 6652 Sfmt 6201 E:\BILLS\H3965.IH H3965 kjohnson on DSK79L0C42 with BILLS 4 •HR 3965 IH ‘‘(5) METHOD FOR DETERMINING ACTUAL 1 CHARGE.—Not later than 18 months after the date 2 of the enactment of the Hospital Price Transparency 3 and Disclosure Act, the Secretary shall pursuant to 4 rulemaking develop a method to determine and make 5 publicly available information on total amounts actu- 6 ally negotiated for and charged by a hospital to pa- 7 tients for the items and services appearing on its 8 standard charge list, and accepted by the hospital as 9 payment in full. In determining the method for the 10 disclosure of such negotiated charges, the Secretary 11 may take steps to reduce the risk of the anti-com- 12 petitive use of such data or market collusion, such 13 as by using averages, ranges, rankings, trends, or 14 other means as the Secretary determines reasonable. 15 ‘‘(6) REPORTS.—Beginning not later than 18 16 months after the date of the enactment of the Hos- 17 pital Price Transparency and Disclosure Act, and 18 annually thereafter, the Secretary shall make public 19 on the Internet site described in paragraph (3)(A) a 20 report analyzing trends in standard and negotiated 21 charges over time, analyzing trends in standard and 22 negotiated rates relative to Medicare payments, and 23 providing recommendations as needed on statutory 24 VerDate Sep 11 2014 02:07 Aug 06, 2019 Jkt 089200 PO 00000 Frm 00004 Fmt 6652 Sfmt 6201 E:\BILLS\H3965.IH H3965 kjohnson on DSK79L0C42 with BILLS 5 •HR 3965 IH changes to increase medical price transparency and 1 public insight into health care pricing.’’. 2 Æ VerDate Sep 11 2014 02:07 Aug 06, 2019 Jkt 089200 PO 00000 Frm 00005 Fmt 6652 Sfmt 6301 E:\BILLS\H3965.IH H3965 kjohnson on DSK79L0C42 with BILLS