I 118TH CONGRESS 1ST SESSION H. R. 2857 To direct the Assistant Secretary for Planning and Evaluation of the Depart- ment of Health and Human Services to conduct an annual study on health care competition and consolidation at the State level. IN THE HOUSE OF REPRESENTATIVES APRIL 25, 2023 Mrs. SPARTZ introduced the following bill; which was referred to the Committee on Energy and Commerce A BILL To direct the Assistant Secretary for Planning and Evalua- tion of the Department of Health and Human Services to conduct an annual study on health care competition and consolidation at the State level. 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 ‘‘Measuring State 4 Healthcare Freedom Act’’. 5 VerDate Sep 11 2014 04:15 May 02, 2023 Jkt 039200 PO 00000 Frm 00001 Fmt 6652 Sfmt 6201 E:\BILLS\H2857.IH H2857 kjohnson on DSK79L0C42PROD with BILLS 2 •HR 2857 IH SEC. 2. ANNUAL STUDY ON HEALTH CARE COMPETITION 1 AND CONSOLIDATION AT STATE LEVEL. 2 (a) IN GENERAL.—Over each of the 10 years fol- 3 lowing the date of enactment of this Act, the Assistant 4 Secretary for Planning and Evaluation of the Department 5 of Health and Human Services (in this section referred 6 to as the ‘‘Assistant Secretary’’) shall conduct a study on 7 health care competition and consolidation at the State 8 level. 9 (b) CONSULTATION.—In conducting the study under 10 this section, the Assistant Secretary shall consult with the 11 Chair of the Federal Trade Commission and the Assistant 12 Attorney General in charge of the Antitrust Division of 13 the Department of Justice. 14 (c) OBTAINING DATA.—The Assistant Secretary may 15 secure from the Federal Trade Commission information 16 necessary to enable the Assistant Secretary to carry out 17 subsection (d)(2). Upon request of the Assistant Sec- 18 retary, the Chair of the Federal Trade Commission shall 19 furnish that information to the Assistant Secretary. 20 (d) METRICS.—The study under this section shall in- 21 clude data collection on each of the following: 22 (1) Licensing requirements for doctors, nurses, 23 and other health care practitioners, including re- 24 quirements with respect to— 25 (A) initial licensure; 26 VerDate Sep 11 2014 04:15 May 02, 2023 Jkt 039200 PO 00000 Frm 00002 Fmt 6652 Sfmt 6201 E:\BILLS\H2857.IH H2857 kjohnson on DSK79L0C42PROD with BILLS 3 •HR 2857 IH (B) ongoing maintenance of licensure; 1 (C) specific training and postgraduate and 2 continuing medical education; 3 (D) residency supervisory requirements; 4 and 5 (E) board certification. 6 (2) Mergers and acquisitions (both vertical and 7 horizontal), involving— 8 (A) hospitals; 9 (B) ambulatory or outpatient practices; 10 (C) ambulatory surgical centers; 11 (D) health insurance providers; 12 (E) habilitative service providers (such as 13 providers of physical therapy or occupational 14 therapy); and 15 (F) telehealth. 16 (3) The number of— 17 (A) State laws establishing a legal mecha- 18 nism by which a State approves mergers be- 19 tween or among two or more hospitals (com- 20 monly referred to as ‘‘certificates of public ad- 21 vantage’’); and 22 (B) State laws establishing a legal mecha- 23 nism for regulating the growth of construction 24 VerDate Sep 11 2014 04:15 May 02, 2023 Jkt 039200 PO 00000 Frm 00003 Fmt 6652 Sfmt 6201 E:\BILLS\H2857.IH H2857 kjohnson on DSK79L0C42PROD with BILLS 4 •HR 2857 IH of new health care facilities (commonly referred 1 to as ‘‘certificates of need’’). 2 (4) The availability of alternative forms of 3 health insurance coverage, including— 4 (A) short-term limited duration insurance 5 (as defined for purposes of section 2791(b)(5) 6 of the Public Health Service Act (42 U.S.C. 7 300gg–91(b)(5))); and 8 (B) association health plans (including 9 plans offered through the American Farm Bu- 10 reau Federation). 11 (5) The number of each of the following in op- 12 eration at the start and the end of each year covered 13 by the 10-year study period: 14 (A) Hospitals. 15 (B) Medical practices. 16 (C) Ambulatory or outpatient practices. 17 (D) Ambulatory surgical centers. 18 (E) Health insurance providers. 19 (F) Habilitative service providers. 20 (6) The Herfindahl-Hirschman Index, within 21 geographic areas defined by the Assistant Secretary 22 in consultation with the Bureau of Competition of 23 the Federal Trade Commission, for the following 24 health care services: 25 VerDate Sep 11 2014 04:15 May 02, 2023 Jkt 039200 PO 00000 Frm 00004 Fmt 6652 Sfmt 6201 E:\BILLS\H2857.IH H2857 kjohnson on DSK79L0C42PROD with BILLS 5 •HR 2857 IH (A) General acute care hospital services. 1 (B) Ambulatory or outpatient medical 2 services, disaggregated by medical specialty. 3 (C) Habilitative services. 4 (e) ANNUAL REPORTS.— 5 (1) IN GENERAL.—Not later than the end of 6 each of the 10 years referred to in subsection (a), 7 the Assistant Secretary shall submit to the Com- 8 mittee on Energy and Commerce and the Committee 9 on Ways and Means of the House of Representatives 10 and the Committee on Finance and the Committee 11 on Health, Education, Labor, and Pensions of the 12 Senate a report on the status and results of the 13 study under this section. 14 (2) PUBLICATION; PUBLICLY ACCESSIBLE 15 DATASETS.—Not later than the end of each of the 16 10 years referred to in subsection (a), the Assistant 17 Secretary shall— 18 (A) publish on the website of the Office of 19 the Assistant Secretary the report submitted 20 under paragraph (1) for the respective year; 21 and 22 (B) make the data collected through the 23 study under this section available to the public 24 VerDate Sep 11 2014 04:15 May 02, 2023 Jkt 039200 PO 00000 Frm 00005 Fmt 6652 Sfmt 6201 E:\BILLS\H2857.IH H2857 kjohnson on DSK79L0C42PROD with BILLS 6 •HR 2857 IH on such website in a manner that is publicly ac- 1 cessible and interactive. 2 Æ VerDate Sep 11 2014 04:15 May 02, 2023 Jkt 039200 PO 00000 Frm 00006 Fmt 6652 Sfmt 6301 E:\BILLS\H2857.IH H2857 kjohnson on DSK79L0C42PROD with BILLS