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Lower Costs, More Transparency Act of 2026
Introduced Jun 23, 2026 · Last action Jul 21, 2026 — Ordered to be Reported in the Nature of a Substitute by the Yeas and Nays: 45 - 0.
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Summary
This legislation is called the Lower Costs, More Transparency Act of 2026. Ordered to be Reported in the Nature of a Substitute by the Yeas and Nays: 45 - 0.
Full bill text
[Congressional Bills 119th Congress]
[From the U.S. Government Publishing Office]
[H.R. 9393 Introduced in House (IH)]
<DOC>
119th CONGRESS
2d Session
H. R. 9393
To promote price transparency in the health care sector.
_______________________________________________________________________
IN THE HOUSE OF REPRESENTATIVES
June 23, 2026
Mr. Guthrie (for himself and Mr. Pallone) introduced the following
bill; which was referred to the Committee on Energy and Commerce, and
in addition to the Committees on Ways and Means, and Education and
Workforce, for a period to be subsequently determined by the Speaker,
in each case for consideration of such provisions as fall within the
jurisdiction of the committee concerned
_______________________________________________________________________
A BILL
To promote price transparency in the health care sector.
Be it enacted by the Senate and House of Representatives of the
United States of America in Congress assembled,
SECTION 1. SHORT TITLE.
This Act may be cited as the ``Lower Costs, More Transparency Act
of 2026''.
SEC. 2. HOSPITAL PRICE TRANSPARENCY.
(a) Medicare.--
(1) In general.--Part E of title XVIII of the Social
Security Act (42 U.S.C. 1395x et seq.) is amended by adding at
the end the following new section:
``SEC. 1899D. HOSPITAL PRICE TRANSPARENCY.
``(a) Transparency Requirement.--
``(1) In general.--Beginning January 1, 2028, each
specified hospital that receives payment under this title for
furnishing items and services shall comply with the price
transparency requirement described in paragraph (2).
``(2) Requirement described.--
``(A) In general.--For purposes of paragraph (1),
the price transparency requirement described in this
paragraph is, with respect to a specified hospital,
that such hospital, in accordance with a method and
format established by the Secretary under subparagraph
(C), compile and make public (without subscription and
free of charge) for each year--
``(i) all of the hospital's standard
charges (including the information described in
subparagraph (B)) for each item and service
furnished by such hospital;
``(ii) information in a consumer-friendly
format (as specified by the Secretary)--
``(I) on the hospital's prices
(including the information described in
subparagraph (B)) for as many of the
Centers for Medicare & Medicaid
Services-specified shoppable services
that are furnished by the hospital, and
as many additional hospital-selected
shoppable services (or all such
additional services, if such hospital
furnishes fewer than 300 shoppable
services) as may be necessary for a
combined total of at least 300
shoppable services; and
``(II) that includes, with respect
to each Centers for Medicare & Medicaid
Services-specified shoppable service
that is not furnished by the hospital,
an indication that such service is not
so furnished;
``(iii) each type 2 national provider
identifier associated with the hospital or a
unit of the hospital; and
``(iv) an attestation that all information
made public pursuant to this subparagraph is
complete and accurate.
``(B) Information described.--For purposes of
subparagraph (A), the information described in this
subparagraph is, with respect to standard charges and
prices, as applicable, made public by a specified
hospital, the following:
``(i) A plain language description (as
specified by the Secretary) of each item or
service, accompanied by, as applicable, the
Healthcare Common Procedure Coding System code,
the diagnosis-related group, the national drug
code, or other identifier used or approved by
the Centers for Medicare & Medicaid Services.
``(ii) The gross charge, as applicable,
expressed as a dollar amount, for each such
item or service, when provided in, as
applicable, the inpatient setting and
outpatient department setting.
``(iii) For each such item or service when
provided in, as applicable, the inpatient and
outpatient department settings--
``(I) the discounted cash price, as
applicable, expressed as a dollar
amount; or
``(II) in the case no discounted
cash price is available for such item
or service, the median cash price
charged by the hospital (not including
charity care) to self-pay individuals
for such item or service when provided
in such settings for the previous three
years, expressed as a dollar amount.
``(iv) With respect to prices made public
pursuant to subparagraph (A)(ii), a link to a
consumer-friendly document that clearly
explains the hospital's charity care policy
that includes, if applicable, any sliding scale
payment structure employed for determining
prices.
``(v) The payer-specific negotiated
charges, as applicable, clearly associated with
the name of the third party payer and plan and
expressed as a dollar amount, that apply to
each such item or service when provided in, as
applicable, the inpatient setting and
outpatient department setting.
``(vi) The de-identified maximum and
minimum negotiated charges, as applicable, for
each such item or service, not including any
such charge that is $0.
``(vii) Any other additional information
the Secretary may require (in consultation with
stakeholders) for the purpose of improving the
accuracy of, or enabling consumers to easily
understand and compare, standard charges and
prices for an item or service, except
information that is duplicative of any other
reporting requirement under this subsection.
``(C) Uniform method and format.--Not later than
January 1, 2028, the Secretary shall establish a
standard, uniform method and format for specified
hospitals to use in compiling and making public
standard charges pursuant to subparagraph (A)(i) and a
standard, uniform method and format for such hospitals
to use in compiling and making public prices pursuant
to subparagraph (A)(ii). Such methods and formats--
``(i) shall, in the case of such method and
format for making public standard charges
pursuant to subparagraph (A)(i), ensure that
such charges are made available in a machine-
readable format (or a successor technology
specified by the Secretary);
``(ii) may be similar to any template made
available by the Centers for Medicare &
Medicaid Services as of the date of the
enactment of this subparagraph;
``(iii) shall meet such standards as
determined appropriate by the Secretary in
order to ensure the accessibility and usability
of such charges and prices; and
``(iv) shall be updated as determined
appropriate by the Secretary, in consultation
with stakeholders.
``(3) Monitoring compliance.--The Secretary shall establish
processes to monitor and assess specified hospitals' compliance
with this subsection. Such processes shall include processes
relating to the following:
``(A) The evaluation and analysis of complaints
made by individuals or other entities relating to such
hospitals' compliance with this subsection.
``(B) The use of audits to ensure such hospitals'
compliance with this subsection.
``(C) The obtaining of additional information from
such hospitals to determine such hospitals' compliance
with this subsection (as determined appropriate by the
Secretary).
``(4) Enforcement.--
``(A) In general.--In the case of a specified
hospital that fails to comply with the requirements of
this subsection--
``(i) not later than 30 days after the date
on which the Secretary determines such failure
exists, the Secretary shall submit to such
hospital a notification of such determination
(which may include, as determined appropriate
by the Secretary, a request for a corrective
action plan (to be submitted not later than 45
days after such request is made) to comply with
such requirements); and
``(ii) in the case of a hospital that does
not receive a request for a corrective action
plan as part of a notification submitted by the
Secretary under clause (i)--
``(I) the Secretary shall, not
later than 60 days after such
notification is sent, determine whether
such hospital is in compliance with
such requirements; and
``(II) if the Secretary determines
under subclause (I) that such hospital
is not in compliance with such
requirements, the Secretary shall
either--
``(aa) submit to such
hospital a request for a
corrective action plan (to be
submitted not later than 45
days after such request is
made) to comply with such
requirements; or
``(bb) if the Secretary
determines that such hospital
has not taken meaningful
actions to come into compliance
since such notification was
sent, impose a civil monetary
penalty in accordance with
subparagraph (B).
``(B) Civil monetary penalty.--
``(i) In general.--Subject to clause (vii),
in addition to any other enforcement actions or
penalties that may apply under another
provision of Federal law, a specified hospital
that has received a request for a corrective
action plan under clause (i) or (ii) of
subparagraph (A) and fails to comply with the
requirements of this subsection by the date
that is 90 days after such request is made (or,
if such hospital has submitted such a
corrective action plan not later than 45 days
after the date such request was made, by the
date that is 90 days after the date of the
submission of such corrective action plan), and
a specified hospital with respect to which the
Secretary has made a determination described in
clause (ii)(II)(bb) of such subparagraph, shall
be subject to a civil monetary penalty of an
amount specified by the Secretary for each day
(beginning with the day on which the Secretary
first determined that such hospital was not
complying with such requirements) during which
such failure was ongoing. Such amount shall not
exceed--
``(I) in the case of a specified
hospital with 30 or fewer beds, $300
per day (or, in the case of such a
hospital that has been noncompliant
with such requirements for a 1-year
period or longer, beginning with the
first day following such 1-year period,
$400 per day);
``(II) in the case of a specified
hospital with more than 30 beds but
fewer than 101 beds, $12.50 per bed per
day (or, in the case of such a hospital
that has been noncompliant with such
requirements for a 1-year period or
longer, beginning with the first day
following such 1-year period, $15 per
bed per day);
``(III) in the case of a specified
hospital with more than 100 beds but
fewer than 201 beds, $17.50 per bed per
day (or, in the case of such a hospital
that has been noncompliant with such
requirements for a 1-year period or
longer, beginning with the first day
following such 1-year period, $20 per
bed per day);
``(IV) in the case of a specified
hospital with more than 200 beds but
fewer than 501 beds, $20 per bed per
day (or, in the case of such a hospital
that has been noncompliant with such
requirements for a 1-year period or
longer, beginning with the first day
following such 1-year period, $25 per
bed per day); and
``(V) in the case of a specified
hospital with more than 500 beds, $25
per bed per day (or, in the case of
such a hospital that has been
noncompliant with such requirements for
a 1-year period or longer, beginning
with the first day following such 1-
year period, $35 per bed per day).
``(ii) Increase authority.--In applying
this subparagraph with respect to violations
occurring in 2029 or a subsequent year, the
Secretary may through notice and comment
rulemaking increase--
``(I) the limitation on the per day
amount of any penalty applicable to a
specified hospital under clause (i)(I);
``(II) the limitations on the per
bed per day amount of any penalty
applicable under any of subclauses (II)
through (V) of clause (i); and
``(III) the amounts specified in
clause (iii)(II).
``(iii) Persistent noncompliance.--
``(I) In general.--In the case of a
specified hospital (other than a
specified hospital with 30 or fewer
beds) that the Secretary has determined
to be knowingly and willfully
noncompliant with the provisions of
this subsection for two or more 6-month
periods during any 3-year period, the
Secretary may increase any penalty
otherwise applicable under this
subparagraph by the amount specified in
subclause (II) with respect to such
hospital and may require such hospital
to complete such additional corrective
actions plans as the Secretary may
specify.
``(II) Specified amount.--For
purposes of subclause (I), the amount
specified in this subclause is, with
respect to a specified hospital--
``(aa) with more than 30
beds but fewer than 101 beds,
an amount that is not less than
$500,000 and not more than
$1,000,000;
``(bb) with more than 100
beds but fewer than 301 beds,
an amount that is greater than
$1,000,000 and not more than
$2,000,000;
``(cc) with more than 300
beds but fewer than 501 beds,
an amount that is greater than
$2,000,000 and not more than
$4,000,000; and
``(dd) with more than 500
beds, and amount that is not
less than $5,000,000 and not
more than $10,000,000.
``(iv) Authority to waive or reduce
penalty.--
``(I) Hospitals located in rural or
underserved areas.--
``(aa) In general.--Subject
to item (bb), the Secretary may
waive any penalty, or reduce
any penalty by not more than 75
percent, otherwise applicable
under this subparagraph with
respect to a specified hospital
located in a rural or
underserved area if the
Secretary certifies that
imposition of such penalty
would result in an immediate
threat to access to care for
individuals in the service area
of such hospital.
``(bb) Limitation on
application.--The Secretary may
not elect to waive a penalty
under item (aa) with respect to
a specified hospital more than
once in a 6-year period and may
not elect to reduce such a
penalty with respect to such a
hospital more than once in such
a period. Nothing in the
preceding sentence shall be
construed as prohibiting the
Secretary from both waiving and
reducing a penalty with respect
to a specified hospital during
a 6-year period.
``(II) Reduction if hearing
waived.--The Secretary may reduce any
penalty otherwise applicable under this
subparagraph (as reduced, if
applicable, under subclause (I)) by not
more than 35 percent if the specified
hospital that is the subject of such
penalty agrees to waive any right of
such hospital to a hearing before an
administrative law judge with respect
to the imposition of such penalty.
``(v) Hardship exemption.--Notwithstanding
any limit on the waiver or reduction of a
penalty under clause (iv), the Secretary may
waive any penalty with respect to a specified
hospital on a case-by-case basis if the
Secretary determines that a circumstance exists
interfering with such hospital's ability to
comply with the provisions of this subsection
(such as a natural disaster (as defined in
section 602(a) of the Robert T. Stafford
Disaster Relief and Emergency Assistance Act),
a public health emergency, or other similar or
unexpected catastrophe or similar situation).
``(vi) Provision of technical assistance.--
The Secretary shall, to the extent practicable,
provide technical assistance relating to
compliance with the provisions of this
subsection to specified hospitals requesting
such assistance.
``(vii) Application of certain
provisions.--The provisions of section 1128A
(other than subsections (a) and (b) of such
section) shall apply to a civil monetary
penalty imposed under this subparagraph in the
same manner as such provisions apply to a civil
monetary penalty imposed under subsection (a)
of such section.
``(viii) Nonduplication of certain
penalties.--
``(I) In general.--The Secretary
may not subject a specified hospital to
a civil monetary penalty under this
subparagraph with respect to
noncompliance with the provisions of
this subsection for a period if the
Secretary has imposed a civil monetary
penalty on such hospital under section
2718(f) of the Public Health Service
Act for failure to comply with the
provisions of such section for such
period.
``(II) Prioritization.--In the case
of a hospital that the Secretary
determines to be in violation of the
provisions of this subsection and of
section 2718(f) of the Public Health
Service Act, the Secretary shall impose
penalties as prescribed in such section
2718(f) in lieu of any penalties
prescribed in this subsection.
``(C) Publication of hospital price transparency
information.--Beginning on January 1, 2028, the
Secretary shall make publicly available on the public
website of the Centers for Medicare & Medicaid Services
information with respect to compliance with the
requirements of this subsection and enforcement
activities undertaken by the Secretary under this
subsection. Such information shall be updated in real
time (if practicable) and include--
``(i) the number of reviews of compliance
with this subsection undertaken by the
Secretary;
``(ii) the number of notifications
described in subparagraph (A)(i) sent by the
Secretary;
``(iii) the identity of each specified
hospital that was sent such a notification and
a description of the nature of such hospital's
noncompliance with this subsection;
``(iv) the amount of any civil monetary
penalty imposed on such hospital under
subparagraph (B);
``(v) whether such hospital subsequently
came into compliance with this subsection;
``(vi) any waivers or reductions of
penalties made pursuant to a certification by
the Secretary under subparagraph (B)(iv),
including--
``(I) the name of any specified
hospital that received such a waiver or
reduction;
``(II) the dollar amount of each
such penalty so waived or reduced; and
``(III) the rationale for the
granting of each such waiver or
reduction, but only to the extent that
such rationale does not make public
commercially sensitive information; and
``(vii) any other information as determined
by the Secretary.
``(b) Ensuring Accessibility Through Implementation.--In
implementing this section, the Secretary shall through rulemaking
ensure that a hospital making public charges and prices pursuant to
this section takes reasonable steps (as specified by the Secretary) to
ensure the accessibility of such charges and information to individuals
with limited English proficiency. Such steps may include the hospital's
provision of interpretation services or the hospital's provision of
translations of charges and information.
``(c) Definitions.--For purposes of this section:
``(1) Discounted cash price.--The term `discounted cash
price' means the charge that applies to an individual who pays
cash, or cash equivalent, for an item or service.
``(2) Gross charge.--The term `gross charge' means the
charge for an individual item or service that is reflected on a
specified hospital's chargemaster or provider of service or
supplier's, as applicable, chargemaster (or similar list of
prices), absent any discounts.
``(3) Payer-specific negotiated charge.--The term `payer-
specific negotiated charge' means the charge that a hospital
has negotiated with a third party payer for an item or service.
``(4) Shoppable service.--The term `shoppable service'
means a service that can be scheduled by a health care consumer
in advance and includes all ancillary items and services
customarily furnished as part of such service.
``(5) Specified hospital.--The term `specified hospital'
means a hospital (as defined in section 1861(e)), a critical
access hospital (as defined in section 1861(mmm)(1)), or a
rural emergency hospital (as defined in section 1861(kkk)).
``(6) Third party payer.--The term `third party payer'
means an entity that is, by statute, contract, or agreement,
legally responsible for payment of a claim for a health care
item or service.''.
(2) Rule of construction.--Nothing in the amendments made
by this subsection may be construed to impede, prohibit, or
prevent the Secretary of Health and Human Services from
implementing, executing, carrying out, or enforcing the
requirements of section 2718(f) of the Public Health Service
Act.
(b) PHSA.--
(1) In general.--Section 2718 of the Public Health Service
Act (42 U.S.C. 300gg-18) is amended by adding at the end the
following new subsection:
``(f) Hospital Transparency Requirement.--
``(1) In general.--Beginning January 1, 2028, each hospital
operating within the United States (including a specified
hospital (as defined in section 1899D of the Social Security
Act)) shall comply with the price transparency requirement
described in paragraph (2).
``(2) Requirement described.--
``(A) In general.--For purposes of paragraph (1),
the price transparency requirement described in this
paragraph is, with respect to a hospital, that such
hospital, in accordance with a method and format
established by the Secretary under subparagraph (C),
compile and make public (without subscription and free
of charge) for each year--
``(i) all of the hospital's standard
charges (including the information described in
subparagraph (B)) for each item and service
furnished by such hospital;
``(ii) information in a consumer-friendly
format (as specified by the Secretary)--
``(I) on the hospital's prices
(including the information described in
subparagraph (B)) for as many of the
Centers for Medicare & Medicaid
Services-specified shoppable services
that are furnished by the hospital, and
as many additional hospital-selected
shoppable services (or all such
additional services, if such hospital
furnishes fewer than 300 shoppable
services) as may be necessary for a
combined total of at least 300
shoppable services; and
``(II) that includes, with respect
to each Centers for Medicare & Medicaid
Services-specified shoppable service
that is not furnished by the hospital,
an indication that such service is not
so furnished;
``(iii) each type 2 national provider
identifier associated with the hospital or a
unit of the hospital; and
``(iv) an attestation that all information
made public pursuant to this subparagraph is
complete and accurate.
``(B) Information described.--For purposes of
subparagraph (A), the information described in this
subparagraph is, with respect to standard charges and
prices, as applicable, made public by a hospital, the
following:
``(i) A plain language description (as
specified by the Secretary) of each item or
service, accompanied by, as applicable, the
Healthcare Common Procedure Coding System code,
the diagnosis-related group, the national drug
code, current procedure terminology codes, or
other identifier used or approved by the
Centers for Medicare & Medicaid Services.
``(ii) The gross charge, as applicable,
expressed as a dollar amount (as specified by
the Secretary), for each such item or service,
when provided in, as applicable, the inpatient
setting and outpatient department setting.
``(iii) For each such item or service when
provided in, as applicable, the inpatient and
outpatient department settings--
``(I) the discounted cash price, as
applicable, expressed as a dollar
amount; or
``(II) in the case no discounted
cash price is available for such item
or service, the median cash price
charged by the hospital (not including
charity care) to self-pay individuals
for such item or service when provided
in such settings for the previous three
years, expressed as a dollar amount.
``(iv) With respect to prices made public
pursuant to subparagraph (A)(ii), a link to a
consumer-friendly document that clearly
explains the hospital's charity care policy
that includes, if applicable, any sliding scale
payment structure employed for determining
prices.
``(v) The payer-specific negotiated
charges, as applicable, clearly associated with
the name of the third party payer and plan and
expressed as a dollar amount, that apply to
each such item or service when provided in, as
applicable, the inpatient setting and
outpatient department setting.
``(vi) The de-identified maximum and
minimum negotiated charges, as applicable, for
each such item or service, not including any
such charge that is $0.
``(vii) Any other additional information
the Secretary may require (in consultation with
stakeholders) for the purpose of improving the
accuracy of, or enabling consumers to easily
understand and compare, standard charges and
prices for an item or service, except
information that is duplicative of any other
reporting requirement under this subsection.
``(C) Uniform method and format.--Not later than
January 1, 2028, the Secretary shall establish a
standard, uniform method and format for hospitals to
use in compiling and making public standard charges
pursuant to subparagraph (A)(i) and a standard, uniform
method and format for such hospitals to use in
compiling and making public prices pursuant to
subparagraph (A)(ii). Such methods and formats--
``(i) shall, in the case of such method and
format for making public standard charges
pursuant to subparagraph (A)(i), ensure that
such charges are made available in a machine-
readable format (or a successor technology
specified by the Secretary);
``(ii) may be similar to any template made
available by the Centers for Medicare &
Medicaid Services as of the date of the
enactment of this subparagraph;
``(iii) shall meet such standards as
determined appropriate by the Secretary in
order to ensure the accessibility and usability
of such charges and prices; and
``(iv) shall be updated as determined
appropriate by the Secretary, in consultation
with stakeholders.
``(3) Monitoring compliance.--The Secretary shall establish
processes to monitor and assess specified hospitals' compliance
with this subsection. Such processes shall include processes
relating to the following:
``(A) The evaluation and analysis of complaints
made by individuals or other entities relating to such
hospitals' compliance with this subsection.
``(B) The use of audits to ensure such hospitals'
compliance with this subsection.
``(C) The obtaining of additional information from
such hospitals to determine such hospitals' compliance
with this subsection (as determined appropriate by the
Secretary).
``(4) Enforcement.--
``(A) In general.--In the case of a hospital that
fails to comply with the requirements of this
subsection--
``(i) not later than 30 days after the date
on which the Secretary determines such failure
exists, the Secretary shall submit to such
hospital a notification of such determination
(which may include, as determined appropriate
by the Secretary, a request for a corrective
action plan (to be submitted not later than 45
days after such request is made) to comply with
such requirements); and
``(ii) in the case of a hospital that does
not receive a request for a corrective action
plan as part of a notification submitted by the
Secretary under clause (i)--
``(I) the Secretary shall, not
later than 60 days after such
notification is sent, determine whether
such hospital is in compliance with
such requirements; and
``(II) if the Secretary determines
under subclause (I) that such hospital
is not in compliance with such
requirements, the Secretary shall
either--
``(aa) submit to such
hospital a request for a
corrective action plan (to be
submitted not later than 45
days after such request is
made) to comply with such
requirements; or
``(bb) if the Secretary
determines that such hospital
has not taken meaningful
actions to come into compliance
since such notification was
sent, impose a civil monetary
penalty in accordance with
subparagraph (B).
``(B) Civil monetary penalty.--
``(i) In general.--In addition to any other
enforcement actions or penalties that may apply
under another provision of Federal law, a
hospital that has received a request for a
corrective action plan under clause (i) or (ii)
of subparagraph (A) and fails to comply with
the requirements of this subsection by the date
that is 90 days after such request is made (or,
if such hospital has submitted such a
corrective action plan not later than 45 days
after the date such request was made, by the
date that is 90 days after the date of the
submission of such corrective action plan), and
a hospital with respect to which the Secretary
has made a determination described in clause
(ii)(II)(bb) of such subparagraph, shall be
subject to a civil monetary penalty of an
amount specified by the Secretary for each day
(beginning with the day on which the Secretary
first determined that such hospital was not
complying with such requirements) during which
such failure was ongoing. Such amount shall not
exceed--
``(I) in the case of a hospital
with 30 or fewer beds, $300 per day
(or, in the case of such a hospital
that has been noncompliant with such
requirements for a 1-year period or
longer, beginning with the first day
following such 1-year period, $400 per
bed per day);
``(II) in the case of a hospital
with more than 30 beds but fewer than
101 beds, $12.50 per bed per day (or,
in the case of such a hospital that has
been noncompliant with such
requirements for a 1-year period or
longer, beginning with the first day
following such 1-year period, $15 per
bed per day);
``(III) in the case of a hospital
with more than 100 beds but fewer than
201 beds, $17.50 per bed per day (or,
in the case of such a hospital that has
been noncompliant with such
requirements for a 1-year period or
longer, beginning with the first day
following such 1-year period, $20 per
bed per day);
``(IV) in the case of a hospital
with more than 200 beds but fewer than
501 beds, $20 per bed per day (or, in
the case of such a hospital that has
been noncompliant with such
requirements for a 1-year period or
longer, beginning with the first day
following such 1-year period, $25 per
bed per day); and
``(V) in the case of a hospital
with more than 500 beds, $25 per bed
per day (or, in the case of such a
hospital that has been noncompliant
with such requirements for a 1-year
period or longer, beginning with the
first day following such 1-year period,
$35 per bed per day).
``(ii) Increase authority.--In applying
this subparagraph with respect to violations
occurring in 2029 or a subsequent year, the
Secretary may through notice and comment
rulemaking increase--
``(I) the limitation on the per day
amount of any penalty applicable to a
hospital under clause (i)(I);
``(II) the limitations on the per
bed per day amount of any penalty
applicable under any of subclauses (II)
through (V) of clause (i); and
``(III) the amounts specified in
clause (iii)(II).
``(iii) Persistent noncompliance.--
``(I) In general.--In the case of a
hospital (other than a hospital with 30
or fewer beds) that the Secretary has
determined to be knowingly and
willfully noncompliant with the
provisions of this subsection for two
or more 6-month periods during any 3-
year period, the Secretary may increase
any penalty otherwise applicable under
this subparagraph by the amount
specified in subclause (II) with
respect to such hospital and may
require such hospital to complete such
additional corrective actions plans as
the Secretary may specify.
``(II) Specified amount.--For
purposes of subclause (I), the amount
specified in this subclause is, with
respect to a hospital--
``(aa) with more than 30
beds but fewer than 101 beds,
an amount that is not less than
$500,000 and not more than
$1,000,000;
``(bb) with more than 100
beds but fewer than 301 beds,
an amount that is greater than
$1,000,000 and not more than
$2,000,000;
``(cc) with more than 300
beds but fewer than 501 beds,
an amount that is greater than
$2,000,000 and not more than
$4,000,000; and
``(dd) with more than 500
beds, and amount that is not
less than $5,000,000 and not
more than $10,000,000.
``(iv) Authority to waive or reduce
penalty.--
``(I) Hospitals located in rural or
underserved areas.--
``(aa) In general.--Subject
to item (bb), the Secretary may
waive any penalty, or reduce
any penalty by not more than 75
percent, otherwise applicable
under this subparagraph with
respect to a hospital located
in a rural or underserved area
if the Secretary certifies that
imposition of such penalty
would result in an immediate
threat to access to care for
individuals in the service area
of such hospital.
``(bb) Limitation on
application.--The Secretary may
not elect to waive a penalty
under item (aa) with respect to
a hospital more than once in a
6-year period and may not elect
to reduce such a penalty with
respect to such a hospital more
than once in such a period.
Nothing in the preceding
sentence shall be construed as
prohibiting the Secretary from
both waiving and reducing a
penalty with respect to a
hospital during a 6-year
period.
``(II) Reduction if hearing
waived.--The Secretary may reduce any
penalty otherwise applicable under this
subparagraph (as reduced, if
applicable, under subclause (I)) by not
more than 35 percent if the specified
hospital that is subject of such
penalty agrees to waive any right of
such hospital to a hearing before an
administrative law judge with respect
to the imposition of such penalty.
``(v) Provision of technical assistance.--
The Secretary shall, to the extent practicable,
provide technical assistance relating to
compliance with the provisions of this
subsection to hospitals requesting such
assistance.
``(vi) Hardship exemption.--Notwithstanding
any limit on the waiver or reduction of a
penalty under clause (iv), the Secretary may
waive any penalty with respect to a hospital on
a case-by-case basis if the Secretary
determines that a circumstance exists
interfering with such hospital's ability to
comply with the provisions of this subsection
(such as a natural disaster (as defined in
section 602(a) of the Robert T. Stafford
Disaster Relief and Emergency Assistance Act),
a public health emergency, or other similar or
unexpected catastrophe or similar situation).
``(vii) Application of certain
provisions.--The provisions of section 1128A of
the Social Security Act (other than subsections
(a) and (b) of such section) shall apply to a
civil monetary penalty imposed under this
subparagraph in the same manner as such
provisions apply to a civil monetary penalty
imposed under subsection (a) of such section.
``(viii) Nonduplication of penalties.--
``(I) In general.--The Secretary
may not subject a hospital to a civil
monetary penalty under this
subparagraph with respect to
noncompliance with the provisions of
this subsection for a period if the
Secretary has imposed a civil monetary
penalty on such hospital under section
1899D of the Social Security Act for
failure to comply with the provisions
of such section for such period.
``(II) Prioritization.--In the case
of a hospital that the Secretary
determines to be in violation of the
provisions of this subsection and of
section 1899D of the Social Security
Act, the Secretary shall impose
penalties as prescribed in this
subsection in lieu of any penalties
prescribed in such section 1899D.
``(C) Publication of hospital price transparency
information.--Beginning on January 1, 2028, the
Secretary shall make publicly available on the public
website of the Centers for Medicare & Medicaid Services
information with respect to compliance with the
requirements of this subsection and enforcement
activities undertaken by the Secretary under this
subsection. Such information shall be updated in real
time (if practicable) and include--
``(i) the number of reviews of compliance
with this subsection undertaken by the
Secretary;
``(ii) the number of notifications
described in subparagraph (A)(i) sent by the
Secretary;
``(iii) the identity of each hospital that
was sent such a notification and a description
of the nature of such hospital's noncompliance
with this subsection;
``(iv) the amount of any civil monetary
penalty imposed on such hospital under
subparagraph (B);
``(v) whether such hospital subsequently
came into compliance with this subsection;
``(vi) any waivers or reductions of
penalties made pursuant to a certification by
the Secretary under subparagraph (B)(iv),
including--
``(I) the name of any hospital that
received such a waiver or reduction;
``(II) the dollar amount of each
such penalty so waived or reduced; and
``(III) the rationale for the
granting of each such waiver or
reduction, but only to the extent that
such rationale does not make public
commercially sensitive information; and
``(vii) any other information as determined
by the Secretary.
``(5) Ensuring accessibility through implementation.--In
implementing this subsection, the Secretary shall through
rulemaking ensure that a hospital making public charges and
prices pursuant to this section takes reasonable steps (as
specified by the Secretary) to ensure the accessibility of such
charges and information to individuals with limited English
proficiency. Such steps may include the hospital's provision of
interpretation services or the hospital's provision of
translations of charges and information.
``(6) Definitions.--For purposes of this subsection:
``(A) Discounted cash price.--The term `discounted
cash price' means the charge that applies to an
individual who pays cash, or cash equivalent, for a
hospital-furnished item or service.
``(B) Gross charge.--The term `gross charge' means
the charge for an individual item or service that is
reflected on a hospital's chargemaster, absent any
discounts.
``(C) Payer-specific negotiated charge.--The term
`payer-specific negotiated charge' means the charge
that a hospital has negotiated with a third party payer
for an item or service.
``(D) Shoppable service.--The term `shoppable
service' means a service that can be scheduled by a
health care consumer in advance and includes all
ancillary items and services customarily furnished as
part of such service.
``(E) Third party payer.--The term `third party
payer' means an entity that is, by statute, contract,
or agreement, legally responsible for payment of a
claim for a health care item or service.''.
(2) Conforming amendments.--Section 2718 of the Public
Health Service Act (42 U.S.C. 300gg-18) is amended--
(A) in subsection (b)(3), by inserting ``(other
than the provisions of subsection (f))'' after ``this
section''; and
(B) in subsection (e), by adding at the end the
following new sentence: ``The preceding provisions of
this subsection shall not apply beginning on January 1,
2028.''.
(3) Rule of construction.--Nothing in the amendments made
by this subsection may be construed to impede, prohibit, or
prevent the Secretary of Health and Human Services from
implementing, executing, carrying out, or enforcing the
requirements of section 1899D of the Social Security Act.
SEC. 3. CLINICAL DIAGNOSTIC LABORATORY TEST PRICE TRANSPARENCY.
Section 1846 of the Social Security Act (42 U.S.C. 1395w-2) is
amended--
(1) in the header, by inserting ``and additional
requirements'' after ``sanctions''; and
(2) by adding at the end the following new subsection:
``(c) Price Transparency Requirement.--
``(1) In general.--Beginning January 1, 2028, any
applicable laboratory that receives payment under this title
for furnishing any specified clinical diagnostic laboratory
test under this title shall--
``(A) make publicly available on an internet
website the information described in paragraph (2) with
respect to each such specified clinical diagnostic
laboratory test that such laboratory so furnishes;
``(B) ensure that such information is updated not
less frequently than annually; and
``(C) include on the website described in
subparagraph (A) an attestation that all such
information is complete and accurate.
``(2) Information described.--For purposes of paragraph
(1), the information described in this paragraph is, with
respect to an applicable laboratory and a specified clinical
diagnostic laboratory test, the discounted cash price for such
test (or, if no such price exists, the gross charge for such
test).
``(3) Uniform method and format.--Not later than January 1,
2028, the Secretary shall establish a standard, uniform method
and format for applicable laboratories to use in compiling and
making public information pursuant to paragraph (1). Such
method and format--
``(A) may be similar to any template made available
by the Centers for Medicare & Medicaid Services (as
described in section 1899D(a)(2)(C)(ii));
``(B) shall meet such standards as determined
appropriate by the Secretary in order to ensure the
accessibility and usability of such information; and
``(C) shall be updated as determined appropriate by
the Secretary, in consultation with stakeholders.
``(4) Inclusion of ancillary services.--Any price or charge
for a specified clinical diagnostic laboratory test furnished
by an applicable laboratory made publicly available in
accordance with paragraph (1) shall include the price or charge
(as applicable) for any ancillary item or service (such as
specimen collection services) that would normally be furnished
by such laboratory as part of such test, as specified by the
Secretary.
``(5) Enforcement.--
``(A) In general.--In the case that the Secretary
determines that an applicable laboratory is not in
compliance with paragraph (1)--
``(i) not later than 30 days after such
determination, the Secretary shall notify such
laboratory of such determination; and
``(ii) if such laboratory continues to fail
to comply with such paragraph after the date
that is 90 days after such notification is
sent, the Secretary may impose a civil monetary
penalty in an amount not to exceed $300 for
each day (beginning with the day on which the
Secretary first determined that such laboratory
was failing to comply with such paragraph)
during which such failure is ongoing.
``(B) Increase authority.--In applying this
paragraph with respect to violations occurring in 2029
or a subsequent year, the Secretary may through notice
and comment rulemaking increase the per day limitation
on civil monetary penalties under subparagraph (A)(ii).
``(C) Application of certain provisions.--The
provisions of section 1128A (other than subsections (a)
and (b) of such section) shall apply to a civil
monetary penalty imposed under this paragraph in the
same manner as such provisions apply to a civil
monetary penalty imposed under subsection (a) of such
section.
``(6) Provision of technical assistance.--The Secretary
shall, to the extent practicable, provide technical assistance
relating to compliance with the provisions of this subsection
to applicable laboratories requesting such assistance.
``(7) Definitions.--In this subsection:
``(A) Applicable laboratory.--The term `applicable
laboratory' has the meaning given such term in section
414.502, of title 42, Code of Federal Regulations (or a
successor regulation), except that such term does not
include a laboratory with respect to which standard
charges and prices for specified clinical diagnostic
laboratory tests furnished by such laboratory are made
available by--
``(i) a specified hospital pursuant to
section 1899D;
``(ii) a hospital pursuant to section
2718(f) of the Public Health Service Act; or
``(iii) an ambulatory surgical center
pursuant to section 1834(bb).
``(B) Discounted cash price.--The term `discounted
cash price' means the charge that applies to an
individual who pays cash, or cash equivalent, for an
item or service.
``(C) Gross charge.--The term `gross charge' means
the charge for an individual item or service that is
reflected on an applicable laboratory's chargemaster
(or similar list of prices), absent any discounts.
``(D) Specified clinical diagnostic laboratory
test.--the term `specified clinical diagnostic
laboratory test' means a clinical diagnostic laboratory
test that is included on the list of shoppable services
specified by the Centers for Medicare & Medicaid
Services (as described in section
1899D(a)(2)(A)(ii)(I)), other than an advanced
diagnostic laboratory test (as defined in section
1834A(d)(5)).
``(E) Specified hospital.--The term `specified
hospital' has the meaning given such term in section
1899D.''.
SEC. 4. IMAGING PRICE TRANSPARENCY.
Section 1899D of the Social Security Act, as added by section 2, is
amended--
(1) by redesignating subsections (b) and (c) as subsections
(c) and (d), respectively;
(2) by inserting after subsection (a) the following new
subsection:
``(b) Imaging Services Price Transparency.--
``(1) In general.--Beginning January 1, 2028, each provider
of services and supplier that receives payment under this title
for furnishing a specified imaging service, other than such a
provider or supplier with respect to which standard charges and
prices for such services furnished by such provider or supplier
are made available by a specified hospital pursuant to
subsection (a), a hospital pursuant to section 2718(f) of the
Public Health Service Act, or an ambulatory surgical center
pursuant to section 1834(bb), shall--
``(A) make publicly available (in accordance with
paragraph (3)) on an internet website the information
described in paragraph (2) with respect to each such
service that such provider of services or supplier
furnishes;
``(B) ensure that such information is updated not
less frequently than annually; and
``(C) include on the website described in
subparagraph (A) an attestation that all such
information is complete and accurate.
``(2) Information described.--For purposes of paragraph
(1), the information described in this paragraph is, with
respect to a provider of services or supplier and a specified
imaging service, the discounted cash price for such service
(or, if no such price exists, the gross charge for such
service).
``(3) Uniform method and format.--Not later than January 1,
2028, the Secretary shall establish a standard, uniform method
and format for providers of services and suppliers to use in
making public information described in paragraph (2). Any such
method and format--
``(A) may be similar to any template made available
by the Centers for Medicare & Medicaid Services (as
described in subsection (a)(2)(C)(ii));
``(B) shall meet such standards as determined
appropriate by the Secretary in order to ensure the
accessibility and usability of such information; and
``(C) shall be updated as determined appropriate by
the Secretary, in consultation with stakeholders.
``(4) Monitoring compliance.--The Secretary shall, through
notice and comment rulemaking, establish a process to monitor
compliance with this subsection.
``(5) Enforcement.--
``(A) In general.--In the case that the Secretary
determines that a provider of services or supplier is
not in compliance with paragraph (1)--
``(i) not later than 30 days after such
determination, the Secretary shall notify such
provider or supplier of such determination;
``(ii) upon request of the Secretary, such
provider or supplier shall submit to the
Secretary, not later than 45 days after the
date of such request, a corrective action plan
to comply with such paragraph; and
``(iii) if such provider or supplier
continues to fail to comply with such paragraph
after the date that is 90 days after such
notification is sent (or, in the case of such a
provider or supplier that has submitted a
corrective action plan described in clause (ii)
in response to a request so described, after
the date that is 90 days after such
submission), the Secretary may impose a civil
monetary penalty in an amount not to exceed
$300 for each day (beginning with the day on
which the Secretary first determined that such
provider or supplier was failing to comply with
such paragraph) during which such failure to
comply or failure to submit is ongoing.
``(B) Increase authority.--In applying this
paragraph with respect to violations occurring in 2029
or a subsequent year, the Secretary may through notice
and comment rulemaking increase the amount of the civil
monetary penalty under subparagraph (A)(iii).
``(C) Application of certain provisions.--The
provisions of section 1128A (other than subsections (a)
and (b) of such section) shall apply to a civil
monetary penalty imposed under this paragraph in the
same manner as such provisions apply to a civil
monetary penalty imposed under subsection (a) of such
section.
``(D) Authority to waive or reduce penalty.--
``(i) In general.--Subject to clause (ii),
the Secretary may waive or reduce any penalty
otherwise applicable with respect to a provider
of services or supplier under this subparagraph
if the Secretary determines that imposition of
such penalty would result in an immediate
threat to access to care for individuals in the
service area of such provider or supplier.
``(ii) Limitation.--The Secretary may not
elect to waive or reduce a penalty under clause
(i) with respect to a specific provider of
services or supplier more than 3 times in a 10
year period.
``(E) Provision of technical assistance.--The
Secretary shall, to the extent practicable, provide
technical assistance relating to compliance with the
provisions of this subsection to providers of services
and suppliers requesting such assistance.
``(F) Clarification of nonapplicability of other
enforcement provisions.--Notwithstanding any other
provision of this title, this paragraph shall be the
sole means of enforcing the provisions of this
subsection.''; and
(3) in subsection (d), as so redesignated by paragraph (1),
by adding at the end the following new paragraph:
``(5) Specified imaging service.--the term `specified
imaging service' means an imaging service that is included on
the list of Centers for Medicare & Medicaid Services-specified
shoppable services (as described in subsection
(a)(2)(A)(ii)(I)).''.
SEC. 5. AMBULATORY SURGICAL CENTER PRICE TRANSPARENCY.
Section 1834 of the Social Security Act (42 U.S.C. 1395m) is
amended by adding at the end the following new subsection:
``(bb) Ambulatory Surgical Center Price Transparency.--
``(1) In general.--Beginning January 1, 2028, each
ambulatory surgical center that receives payment under this
title for furnishing items and services shall comply with the
price transparency requirement described in paragraph (2).
``(2) Requirement described.--
``(A) In general.--For purposes of paragraph (1),
the price transparency requirement described in this
subsection is, with respect to an ambulatory surgical
center, that such surgical center in accordance with a
method and format established by the Secretary under
subparagraph (C), compile and make public (without
subscription and free of charge), for each year--
``(i) all of the ambulatory surgical
center's standard charges (including the
information described in subparagraph (B)) for
each item and service furnished by such
surgical center;
``(ii) information in a consumer-friendly
format (as specified by the Secretary) on the
ambulatory surgical center's prices (including
the information described in subparagraph (B))
for as many of the Centers for Medicare &
Medicaid Services-specified shoppable services
(as specified by the Secretary) that are
furnished by such surgical center, and as many
additional ambulatory surgical center-selected
shoppable services (or all such additional
services, if such surgical center furnishes
fewer than 300 shoppable services) as may be
necessary for a combined total of at least 300
shoppable services;
``(iii) with respect to each Centers for
Medicare & Medicaid Services-specified
shoppable service that is not furnished by the
ambulatory surgical center, an indication that
such service is not so furnished; and
``(iv) an attestation that all standard
charges described in clause (i), information
described in clause (ii), and indications
described in clause (iii) are complete and
accurate.
``(B) Information described.--For purposes of
subparagraph (A), the information described in this
subparagraph is, with respect to standard charges and
prices, as applicable, made public by an ambulatory
surgical center, the following:
``(i) A plain language description (as
specified by the Secretary) of each item or
service, accompanied by, as applicable, the
Healthcare Common Procedure Coding System code,
the national drug code, or other identifier
used or approved by the Centers for Medicare &
Medicaid Services.
``(ii) The gross charge, as applicable,
expressed as a dollar amount, for each such
item or service.
``(iii) For each such item or service--
``(I) the discounted cash price, as
applicable, expressed as a dollar
amount; or
``(II) in the case no discounted
cash price is available for an item or
service, the median cash price charged
to self-pay individuals for such item
or service for the previous three
years, expressed as a dollar amount.
``(iv) Any other additional information the
Secretary may require (in consultation with
stakeholders) for the purpose of improving the
accuracy of, or enabling consumers to easily
understand and compare, standard charges and
prices for an item or service, except
information that is duplicative of any other
reporting requirement under this subsection.
``(C) Uniform method and format.--Not later than
January 1, 2028, the Secretary shall establish a
standard, uniform method and format for ambulatory
surgical centers to use in making public standard
charges pursuant to subparagraph (A)(i) and a standard,
uniform method and format for such centers to use in
making public prices pursuant to subparagraph (A)(ii).
Any such method and format--
``(i) shall, in the case of such charges
made public by an ambulatory surgical center,
ensure that such charges are made available in
a machine-readable format (or successor
technology);
``(ii) may be similar to any template made
available by the Centers for Medicare &
Medicaid Services (as described in section
1899D(a)(2)(C)(ii));
``(iii) shall meet such standards as
determined appropriate by the Secretary in
order to ensure the accessibility and usability
of such charges and prices; and
``(iv) shall be updated as determined
appropriate by the Secretary, in consultation
with stakeholders.
``(3) Monitoring compliance.--The Secretary shall establish
processes to monitor and assess ambulatory surgical centers'
compliance with this subsection. Such processes shall include
processes relating to the following:
``(A) The evaluation and analysis of complaints
made by individuals or other entities relating to such
centers' compliance with this subsection.
``(B) The use of audits to ensure such centers'
compliance with this subsection.
``(C) The obtaining of additional information from
such centers to determine such centers' compliance with
this subsection (as determined appropriate by the
Secretary).
``(4) Enforcement.--
``(A) In general.--In the case of an ambulatory
surgical center that fails to comply with the
requirements of this subsection--
``(i) the Secretary shall notify such
ambulatory surgical center of such failure not
later than 30 days after the date on which the
Secretary determines such failure exists; and
``(ii) upon request of the Secretary, the
ambulatory surgical center shall submit to the
Secretary, not later than 45 days after the
date of such request, a corrective action plan
to comply with such requirements.
``(B) Civil monetary penalty.--
``(i) In general.--In addition to any other
enforcement actions or penalties that may apply
under another provision of Federal law, an
ambulatory surgical center that has received a
notification under subparagraph (A)(i) and
fails to comply with the requirements of this
subsection by the date that is 90 days after
such notification (or, in the case of an
ambulatory surgical center that has submitted a
corrective action plan described in
subparagraph (A)(ii) in response to a request
so described and has failed to comply with such
requirements by the date that is 90 days after
such submission) shall be subject to a civil
monetary penalty of an amount specified by the
Secretary for each day (beginning with the day
on which the Secretary first determined that
such center was not complying with such
requirements) during which such failure is
ongoing (not to exceed $300 per day).
``(ii) Increase authority.--In applying
this subparagraph with respect to violations
occurring in 2029 or a subsequent year, the
Secretary may through notice and comment
rulemaking increase the limitation on the per
day amount of any penalty applicable to an
ambulatory surgical center under clause (i).
``(iii) Application of certain
provisions.--The provisions of section 1128A
(other than subsections (a) and (b) of such
section) shall apply to a civil monetary
penalty imposed under this subparagraph in the
same manner as such provisions apply to a civil
monetary penalty imposed under subsection (a)
of such section.
``(iv) Authority to waive or reduce
penalty.--
``(I) Centers located in rural or
underserved areas.--
``(aa) In general.--Subject
to item (bb), the Secretary may
waive any penalty, or reduce
any penalty by not more than 75
percent, otherwise applicable
under this subparagraph with
respect to an ambulatory
surgical center located in a
rural or underserved area if
the Secretary certifies that
imposition of such penalty
would result in an immediate
threat to access to care for
individuals in the service area
of such center.
``(bb) Limitation on
application.--The Secretary may
not elect to waive a penalty
under item (aa) with respect to
an ambulatory surgical center
more than once in a 6-year
period and may not elect to
reduce such a penalty with
respect to such a center more
than once in such a period.
Nothing in the preceding
sentence shall be construed as
prohibiting the Secretary from
both waiving and reducing a
penalty with respect to an
ambulatory surgical center
during a 6-year period.
``(II) Reduction if hearing
waived.--The Secretary may reduce any
penalty otherwise applicable under this
subparagraph (as reduced, if
applicable, under subclause (I)) by not
more than 35 percent if the ambulatory
surgical center that is the subject of
such penalty agrees to waive any right
of such center to a hearing before an
administrative law judge with respect
to the imposition of such penalty.
``(5) Provision of technical assistance.--The Secretary
shall, to the extent practicable, provide technical assistance
relating to compliance with the provisions of this subsection
to ambulatory surgical centers requesting such assistance.
``(6) Definitions.--For purposes of this subsection:
``(A) Discounted cash price.--The term `discounted
cash price' means the charge that applies to an
individual who pays cash, or cash equivalent, for an
item or service furnished by an ambulatory surgical
center.
``(B) Gross charge.--The term `gross charge' means
the charge for an individual item or service that is
reflected on an ambulatory surgical center's
chargemaster, absent any discounts.
``(C) Shoppable service.--The term `shoppable
service' means a service that can be scheduled by a
health care consumer in advance and includes all
ancillary items and services customarily furnished as
part of such service.''.
SEC. 6. HEALTH COVERAGE PRICE TRANSPARENCY.
(a) Price Transparency Requirements.--
(1) IRC.--
(A) In general.--Section 9819 of the Internal
Revenue Code of 1986 is amended--
(i) in the header, by striking
``maintenance of price comparison tool'' and
inserting ``transparency in coverage'';
(ii) by striking ``A group health plan''
and inserting the following:
``(a) Maintenance of Price Comparison Tool for Plan Years Before
2028.--
``(1) In general.--A group health plan'';
(iii) in subsection (a), as inserted by
clause (ii), by adding at the end the following
new paragraph:
``(2) Sunset.--Paragraph (1) shall not apply with respect
to plan years beginning on or after January 1, 2028.''; and
(iv) by adding at the end the following new
subsections:
``(b) Cost-sharing Transparency.--
``(1) In general.--For plan years beginning on or after
January 1, 2028, a group health plan shall provide a
participant or beneficiary, in a timely manner upon request of
the participant or beneficiary, information on the amount of
cost-sharing (including deductibles, copayments, and
coinsurance) under the participant or beneficiary's plan that
the participant or beneficiary would be responsible for paying
with respect to the furnishing of a specific item or service by
a provider. At a minimum, such information shall include the
information specified in paragraph (2) and shall be made
available to such participant or beneficiary through a self-
service tool that meets the requirements of paragraph (3) or,
at the option of such participant or beneficiary, through a
paper disclosure or phone or other electronic disclosure (as
selected by such participant or beneficiary and provided at no
cost to such participant or beneficiary) that meets such
requirements as the Secretary may specify.
``(2) Specified information.--For purposes of paragraph
(1), the information specified in this paragraph is, with
respect to an item or service for which benefits are available
under a group health plan furnished by a health care provider
to a participant or beneficiary of such plan, the following:
``(A) If such provider is a participating provider
with respect to such item or service, the in-network
rate for such item or service.
``(B) If such provider is not a participating
provider with respect to such item or service, the
maximum allowed amount or other dollar amount that such
plan will recognize as payment for such item or
service, along with a notice that such participant or
beneficiary may be liable for additional charges.
``(C) The estimated amount of cost sharing
(including deductibles, copayments, and coinsurance)
that the participant or beneficiary will incur for such
item or service (which, in the case such item or
service is to be furnished by a provider described in
subparagraph (B), shall be calculated using the maximum
allowed amount or other dollar amount described in such
subparagraph).
``(D) The amount the participant or beneficiary has
already accumulated with respect to any deductible or
out of pocket maximum under the plan (broken down, in
the case separate deductibles or maximums apply to a
participant and such participant's beneficiaries
enrolled in the plan, by such separate deductibles or
maximums, in addition to any cumulative deductible or
maximum).
``(E) In the case such plan imposes any frequency
or volume limitations with respect to such item or
service (excluding medical necessity determinations),
the amount that such participant or beneficiary has
accrued towards such limitation with respect to such
item or service.
``(F) Any prior authorization, concurrent review,
step therapy, fail first, or similar requirements
applicable to coverage of such item or service under
such plan.
``(G) Any financial incentives (such as any credit,
payment, or other benefit provided by such plan)
available to the participant or beneficiary with
respect to such item or service furnished by such
provider known at the time such request is made.
``(H) In the case such item or service is an
applicable spread price drug dispensed by a pharmacy--
``(i) a specification that such item or
service is such an applicable spread price
drug;
``(ii) the amount of the difference (if
any) between the specified payment amount for
such drug so dispensed by such pharmacy and the
specified reimbursement amount for such drug so
dispensed by such pharmacy;
``(iii) a plain language statement
specified by the Secretary that explains the
concept of spread pricing and how such item's
status as such an applicable spread price drug
may impact the amount such plan pays for such
drug and cost sharing amounts for such drug
described in subparagraph (C); and
``(iv) a plain language statement specified
by the Secretary informing the participant or
beneficiary of the participant's or
beneficiary's ability to obtain a summary
document relating to drug pricing information
described in section 9826(b)(2)(B)(ii).
``(3) Self-service tool.--For purposes of paragraph (1), a
self-service tool established by a group health plan meets the
requirements of this paragraph if such tool--
``(A) is based on an Internet website (or successor
technology specified by the Secretary);
``(B) provides for real-time responses to requests
described in paragraph (1);
``(C) is updated in a manner such that information
provided through such tool is timely and accurate at
the time such request is made;
``(D) allows such a request to be made with respect
to an item or service furnished by--
``(i) a specific provider that is a
participating provider with respect to such
item or service;
``(ii) all providers that are participating
providers with respect to such item or service;
or
``(iii) a provider located in a relevant
geographic region that is not a participating
provider with respect to such item or service;
``(E) provides that such a request may be made with
respect to an item or service through use of the
billing code for such item or service or through use of
a descriptive term for such item or service; and
``(F) meets any other requirement determined
appropriate by the Secretary, including requirements to
ensure the accessibility and usability of information
provided through such tool.
The Secretary may require such tool, as a condition of
complying with subparagraph (E), to link multiple billing codes
to a single descriptive term if the Secretary determines that
the billing codes to be so linked correspond to similar items
and services.
``(c) Rate and Payment Information.--
``(1) In general.--For plan years beginning on or after
January 1, 2028, each group health plan (other than a
grandfathered health plan (as defined in section 1251(e) of the
Patient Protection and Affordable Care Act)) shall make
available to the public the rate and payment information
described in paragraph (2) in accordance with paragraph (3).
``(2) Rate and payment information described.--For purposes
of paragraph (1), the rate and payment information described in
this paragraph is, with respect to a group health plan, the
following:
``(A) With respect to each item or service (other
than a drug) for which benefits are available under
such plan--
``(i) the in-network rate (expressed as a
dollar amount) in effect as of the date on
which such information is made public with each
provider that is a participating provider with
respect to such item or service;
``(ii) with respect to each such provider,
an indication of whether, during the 1-year
period beginning 18 months before the date such
information is made public, such provider
submitted a claim for such item or service to
such plan; and
``(iii) in the case that such plan provides
benefits for such item or service only when
furnished by a specific type of provider, a
specification of each type of provider that may
furnish such item or service under such plan;
``(B) With respect to each drug (identified by
national drug code) for which benefits are available
under such plan--
``(i) the in-network rate (expressed as a
dollar amount) in effect as of the first day of
the month in which such information is made
public with each provider that is a
participating provider with respect to such
drug;
``(ii) the average amount paid by such plan
(accounting for, in a manner determined
appropriate by the Secretary, rebates,
discounts, price concessions, and any other
remuneration specified by the Secretary) for
such drug dispensed or administered during the
90-day period beginning 180 days before such
date of publication to each provider that was a
participating provider with respect to such
drug, broken down by each such provider, unless
fewer than 20 claims for such drug were
submitted to such plan during such period; and
``(iii) in the case such drug is an
applicable spread price drug dispensed by a
pharmacy--
``(I) a specification that such
drug is such an applicable spread price
drug; and
``(II) for each pharmacy that has a
contractual relationship for dispensing
such drug under such plan, a
specification of the difference (if
any) between the specified payment
amount for such drug so dispensed by
such pharmacy and the specified
reimbursement amount for such drug so
dispensed by such pharmacy.
``(C) With respect to each item or service for
which benefits are available under such plan, the
amount billed, and the amount allowed by the plan, for
each such item or service furnished during the 6-month
period beginning 9 months before the date such
information is made public by a provider that was not a
participating provider with respect to such item or
service, broken down by each such provider, other than
such an amount with respect to an item or service
furnished by a provider that, during such period,
submitted fewer than 11 claims for such item or service
to such plan.
``(3) Manner of publication.--
``(A) In general.--Rate and payment information
required to be made available under this subsection
shall be so made available in dollar amounts through
separate machine-readable files (and any successor
technology, as applicable, such as application
programming interface technology, determined
appropriate by the Secretary) corresponding to the
information described in each of subparagraphs (A)
through (C) of paragraph (2) that meet such
requirements as specified by the Secretary (which may
be so specified through subregulatory guidance). Such
requirements shall ensure that such files are limited
to an appropriate size, do not include disclosure of
unnecessary duplicative information contained in other
files made available under this subsection, are made
available in a widely available format through a
publicly available website that allows for information
contained in such files to be compared across group
health plans and group or individual health insurance
coverage, and are accessible to individuals at no cost
and without the need to establish a user account or
provide other credentials.
``(B) Timing.--Rate and payment information--
``(i) described in subparagraph (A) or (B)
of paragraph (2) shall be made public on a
quarterly basis; and
``(ii) described in subparagraph (C) of
paragraph (2) shall be made public on a monthly
basis.
``(4) User instructions.--Each group health plan shall make
available to the public instructions written in plain language
explaining how individuals may search for information described
in paragraph (2) in files submitted in accordance with
paragraph (3). The Secretary shall develop and publish through
subregulatory guidance a template that such a plan may use in
developing instructions for purposes of the preceding sentence.
``(5) Summary.--For each plan year beginning on or after
January 1, 2028, each group health plan shall make public a
data file, in a manner that ensures that such file may be
easily downloaded and read by standard spreadsheet software and
that meets such requirements as established by the Secretary,
containing a summary of all rate and payment information made
public by such plan with respect to such plan during such plan
year. Such file shall include the following:
``(A) The mean, median, and interquartile range of
the in-network rate, and the amount allowed for an item
or service when not furnished by a participating
provider, in effect as of the first day of such plan
year for each item or service (identified by payer
identifier approved or used by the Centers for Medicare
& Medicaid Services) for which benefits are available
under the plan, broken down by the type of provider
furnishing the item or service and by the geographic
area in which such item or service is furnished.
``(B) Trends in payment rates for such items and
services over such plan year, including an
identification of instances in which such rates have
increased, decreased, or remained the same.
``(C) The name of such plan, a description of the
type of network of participating providers used by such
plan, and a description of whether such plan is self-
insured or fully-insured.
``(D) For each item or service which is paid as
part of a bundled or capitated rate--
``(i) a description of the formulae,
pricing methodologies, or other information
used to calculate the payment rate for such
rate; and
``(ii) a list of the items and services
included in such rate.
``(E) The percentage of items and services that are
paid for on a fee-for-service basis and the percentage
of items and services that are paid for as part of a
bundled rate, capitated payment rate, or other
alternative payment model.
``(d) Attestation.--Each group health plan shall annually submit to
the Secretary an attestation of such plan's compliance with the
provisions of this section. Such attestation shall include a link to
the website (or other successor technology) where rate and payment
information required to be made public under subsection (c) may be
accessed.
``(e) Accessibility.--A group health plan shall take reasonable
steps (as specified by the Secretary) to ensure that information
provided in response to a request described in subsection (b), and rate
and payment information made public under subsection (c), is provided
in plain, easily understandable language and that interpretation,
translations, and assistive services are provided to those with limited
English proficiency and those with disabilities.
``(f) PBM Disclosure of Applicable Spread Price Drugs.--An entity
providing pharmacy benefit management services on behalf of a group
health plan shall disclose to such plan, at such time and in such
manner as specified by the Secretary to ensure that information
provided under subsection (b) and rate and payment information made
public under subsection (c) is timely and accurate--
``(1) a list of drugs (identified by national drug codes)
for which benefits are available under such plan that are
applicable spread price drugs; and
``(2) with respect to each drug included on such list and
each pharmacy with a contractual relationship for furnishing
such drug under such plan, a specification of the difference
(if any) between the specified payment amount for such drug so
dispensed by such pharmacy and the specified reimbursement
amount for such drug so dispensed by such pharmacy.
``(g) Definitions.--In this section:
``(1) Applicable spread price drug.--The term `applicable
spread price drug' means, with respect to a group health plan,
a drug for which benefits are available under such plan and
with respect to which, at the time a disclosure described in
subsection (f) is required to be made by an entity providing
pharmacy benefit management services on behalf of such plan--
``(A) a contract is in effect between such entity
and a pharmacy for the dispensing of such drug under
such plan; and
``(B) the specified payment amount for such drug so
dispensed is less than the specified reimbursement
amount for such drug so dispensed.
``(2) In-network rate.--The term `in-network rate' means,
with respect to a group health plan and an item or service
furnished by a provider that is a participating provider with
respect to such plan and item or service, the contracted rate
(reflected as a dollar amount) in effect between such plan and
such provider for such item or service, regardless of whether
such rate is calculated based on a set amount, a fee schedule,
or an amount derived from another amount, or a formula, or
other method.
``(3) Participating provider.--The term `participating
provider' means, with respect to an item or service and a group
health plan, a physician or other health care provider (as
defined in paragraph (4)) who is acting within the scope of
practice of that provider's license or certification under
applicable State law and who has a contractual relationship
with the plan for furnishing such item or service under the
plan.
``(4) Provider.--The term `provider' includes a health care
facility and a pharmacy.
``(5) Specified payment amount.--The term `specified
payment amount' means, with respect to a drug to be dispensed
by a pharmacy to a participant or beneficiary of a group health
plan where such pharmacy has in effect a contract with an
entity providing pharmacy benefit management services on behalf
of such plan for the dispensing of such drug under such plan,
the amount that such entity has agreed to pay such pharmacy for
the ingredient costs and any applicable dispensing fee for such
drug (or the amount that such entity has agreed to pay such
pharmacy for such drug under any other compensation structure
specified by the Secretary) under such contract, taking into
account any cost sharing requirement applicable to such drug
and participant or beneficiary.
``(6) Specified reimbursement amount.--The term `specified
reimbursement amount' means, with respect to a drug to be
dispensed by a pharmacy to a participant or beneficiary of a
group health plan where such pharmacy has in effect a contract
with an entity providing pharmacy benefit management services
on behalf of such plan for the dispensing of such drug under
such plan, that amount that such plan has agreed to pay to such
entity for the ingredient costs and any applicable dispensing
fee for such drug (or the amount that such plan has agreed to
pay such entity for such drug under any other compensation
structure specified by the Secretary), taking into account any
cost sharing requirement applicable to such drug and
participant or beneficiary.''.
(B) Clerical amendment.--The item relating to
section 9819 of the table of sections for subchapter B
of chapter 100 of the Internal Revenue Code of 1986 is
amended to read as follows:
``Sec. 9819. Transparency in coverage.''.
(2) PHSA.--Section 2799A-4 of the Public Health Service Act
(42 U.S.C. 300gg-114) is amended--
(A) in the header, by striking ``maintenance of
price comparison tool'' and inserting ``transparency in
coverage'';
(B) by striking ``A group health plan'' and
inserting the following:
``(a) Maintenance of Price Comparison Tool for Plan Years Before
2028.--
``(1) In general.--A group health plan'';
(C) in subsection (a), as inserted by subparagraph
(B), by adding at the end the following new paragraph:
``(2) Sunset.--Paragraph (1) shall not apply with respect
to plan years beginning on or after January 1, 2028.''; and
(D) by adding at the end the following new
subsections:
``(b) Cost-sharing Transparency.--
``(1) In general.--For plan years beginning on or after
January 1, 2028, a group health plan and a health insurance
issuer offering group or individual health insurance coverage
shall provide a participant, beneficiary, or enrollee, in a
timely manner upon request of the participant, beneficiary, or
enrollee, information on the amount of cost-sharing (including
deductibles, copayments, and coinsurance) under the
participant, beneficiary, or enrollee's plan or coverage that
the participant, beneficiary, or enrollee would be responsible
for paying with respect to the furnishing of a specific item or
service by a provider. At a minimum, such information shall
include the information specified in paragraph (2) and shall be
made available to such participant, beneficiary, or enrollee
through a self-service tool that meets the requirements of
paragraph (3) or, at the option of such participant,
beneficiary, or enrollee, through a paper disclosure or phone
or other electronic disclosure (as selected by such individual
and provided at no cost to such individual) that meets such
requirements as the Secretary may specify.
``(2) Specified information.--For purposes of paragraph
(1), the information specified in this paragraph is, with
respect to an item or service for which benefits are available
under a group health plan or group or individual health
insurance coverage furnished by a health care provider to an
individual enrolled under such plan or coverage, the following:
``(A) If such provider is a participating provider
with respect to such item or service, the in-network
rate for such item or service.
``(B) If such provider is not a participating
provider with respect to such item or service, the
maximum allowed amount or other dollar amount that such
plan or coverage will recognize as payment for such
item or service, along with a notice that such
individual may be liable for additional charges.
``(C) The estimated amount of cost sharing
(including deductibles, copayments, and coinsurance)
that the individual will incur for such item or service
(which, in the case such item or service is to be
furnished by a provider described in subparagraph (B),
shall be calculated using the maximum allowed amount or
other dollar amount described in such subparagraph).
``(D) The amount the individual has already
accumulated with respect to any deductible or out of
pocket maximum under the plan or coverage (broken down,
in the case separate deductibles or maximums apply to
individuals enrolled in the plan or coverage, by such
separate deductibles or maximums, in addition to any
cumulative deductible or maximum).
``(E) In the case such plan imposes any frequency
or volume limitations with respect to such item or
service (excluding medical necessity determinations),
the amount that such individual has accrued towards
such limitation with respect to such item or service.
``(F) Any prior authorization, concurrent review,
step therapy, fail first, or similar requirements
applicable to coverage of such item or service under
such plan or coverage.
``(G) Any financial incentives (such as any credit,
payment, or other benefit provided by such plan or
issuer) available to the individual with respect to
such item or service furnished by such provider known
at the time such request is made.
``(H) In the case such item or service is an
applicable spread price drug dispensed by a pharmacy--
``(i) a specification that such item or
service is such an applicable spread price
drug;
``(ii) the amount of the difference (if
any) between the specified payment amount for
such drug so dispensed by such pharmacy and the
specified reimbursement amount for such drug so
dispensed by such pharmacy;
``(iii) a plain language statement
specified by the Secretary that explains the
concept of spread pricing and how such item's
status as such an applicable spread price drug
may impact the amount such plan or coverage
pays for such drug and cost sharing amounts for
such drug described in subparagraph (C); and
``(iv) except in the case of individual
health insurance coverage, a plain language
statement specified by the Secretary informing
the participant or beneficiary of the
participant's or beneficiary's ability to
obtain a summary document relating to drug
pricing information described in section 2799A-
11(b)(2)(B)(ii).
``(3) Self-service tool.--For purposes of paragraph (1), a
self-service tool established by a group health plan or health
insurance issuer offering group or individual health insurance
coverage meets the requirements of this paragraph if such
tool--
``(A) is based on an internet website (or successor
technology specified by the Secretary);
``(B) provides for real-time responses to requests
described in paragraph (1);
``(C) is updated in a manner such that information
provided through such tool is timely and accurate at
the time such request is made;
``(D) allows such a request to be made with respect
to an item or service furnished by--
``(i) a specific provider that is a
participating provider with respect to such
item or service;
``(ii) all providers that are participating
providers with respect to such item or service;
or
``(iii) a provider located in a relevant
geographic region that is not a participating
provider with respect to such item or service;
``(E) provides that such a request may be made with
respect to an item or service through use of the
billing code for such item or service or through use of
a descriptive term for such item or service; and
``(F) meets any other requirement determined
appropriate by the Secretary, including requirements to
ensure the accessibility and usability of information
provided through such tool.
The Secretary may require such tool, as a condition of
complying with subparagraph (E), to link multiple billing codes
to a single descriptive term if the Secretary determines that
the billing codes to be so linked correspond to similar items
and services.
``(c) Rate and Payment Information.--
``(1) In general.--For plan years beginning on or after
January 1, 2028, each group health plan and health insurance
issuer offering group or individual health insurance coverage
(other than a grandfathered health plan (as defined in section
1251(e) of the Patient Protection and Affordable Care Act))
shall make available to the public the rate and payment
information described in paragraph (2) in accordance with
paragraph (3).
``(2) Rate and payment information described.--For purposes
of paragraph (1), the rate and payment information described in
this paragraph is, with respect to a group health plan or group
or individual health insurance coverage, the following:
``(A) With respect to each item or service (other
than a drug) for which benefits are available under
such plan or coverage,--
``(i) the in-network rate (expressed as a
dollar amount) in effect as of the date on
which such information is made public with each
provider that is a participating provider with
respect to such item or service;
``(ii) with respect to each such provider,
an indication of whether, during the 1-year
period beginning 18 months before the date such
information is made public, such provider
submitted a claim for such item or service to
such plan or coverage; and
``(iii) in the case that such plan or
coverage provides benefits for such item or
service only when furnished by a specific type
of provider, a specification of each type of
provider that may furnish such item or service
under such plan or coverage;
``(B) With respect to each drug (identified by
national drug code) for which benefits are available
under such plan or coverage--
``(i) the in-network rate (expressed as a
dollar amount) in effect as of the first day of
the month in which such information is made
public with each provider that is a
participating provider with respect to such
drug;
``(ii) the average amount paid by such plan
or coverage (accounting for, in a manner
determined appropriate by the Secretary,
rebates, discounts, price concessions, and any
other remuneration specified by the Secretary)
for such drug dispensed or administered during
the 90-day period beginning 180 days before
such date of publication to each provider that
was a participating provider with respect to
such drug, broken down by each such provider,
unless fewer than 20 claims for such drug were
submitted to such plan or coverage during such
period; and
``(iii) in the case such drug is an
applicable spread price drug dispensed by a
pharmacy--
``(I) a specification that such
drug is such an applicable spread price
drug; and
``(II) for each pharmacy that has a
contractual relationship for dispensing
such drug under such plan or coverage,
a specification of the difference (if
any) between the specified payment
amount for such drug so dispensed by
such pharmacy and the specified
reimbursement amount for such drug so
dispensed by such pharmacy.
``(C) With respect to each item or service for
which benefits are available under such plan or
coverage, the amount billed, and the amount allowed by
the plan, for each such item or service furnished
during the 6-month period beginning 9 months before the
date such information is made public by a provider that
was not a participating provider with respect to such
item or service, broken down by each such provider,
other than such an amount with respect to an item or
service furnished by a provider that, during such
period, submitted fewer than 11 claims for such item or
service to such plan or coverage.
``(3) Manner of publication.--
``(A) In general.--Rate and payment information
required to be made available under this subsection
shall be so made available in dollar amounts through
separate machine-readable files (and any successor
technology, as applicable, such as application
programming interface technology, determined
appropriate by the Secretary) corresponding to the
information described in each of subparagraphs (A)
through (C) of paragraph (2) that meet such
requirements as specified by the Secretary (which may
be so specified through subregulatory guidance). Such
requirements shall ensure that such files are limited
to an appropriate size, do not include disclosure of
unnecessary duplicative information contained in other
files made available under this subsection, are made
available in a widely-available format through a
publicly-available website that allows for information
contained in such files to be compared across group
health plans and group or individual health insurance
coverage, and are accessible to individuals at no cost
and without the need to establish a user account or
provide other credentials.
``(B) Timing.--Rate and payment information--
``(i) described in subparagraph (A) or (B)
of paragraph (2) shall be made public on a
quarterly basis; and
``(ii) described in subparagraph (C) of
paragraph (2) shall be made public on a monthly
basis.
``(4) User instructions.--Each group health plan and health
insurance issuer offering group or individual health insurance
coverage shall make available to the public instructions
written in plain language explaining how individuals may search
for information described in paragraph (2) in files submitted
in accordance with paragraph (3). The Secretary shall develop
and publish through subregulatory guidance a template that such
a plan may use in developing instructions for purposes of the
preceding sentence.
``(5) Summary.--For each plan year beginning on or after
January 1, 2028, each group health plan and health insurance
issuer offering group or individual health insurance coverage
shall make public a data file, in a manner that ensures that
such file may be easily downloaded and read by standard
spreadsheet software and that meets such requirements as
established by the Secretary, containing a summary of all rate
and payment information made public by such plan or issuer with
respect to such plan or coverage during such plan year. Such
file shall include the following:
``(A) The mean, median, and interquartile range of
the in-network rate, and the amount allowed for an item
or service when not furnished by a participating
provider, in effect as of the first day of such plan
year for each item or service (identified by payer
identifier approved or used by the Centers for Medicare
& Medicaid Services) for which benefits are available
under the plan or coverage, broken down by the type of
provider furnishing the item or service and by the
geographic area in which such item or service is
furnished.
``(B) Trends in payment rates for such items and
services over such plan year, including an
identification of instances in which such rates have
increased, decreased, or remained the same.
``(C) The name of such plan, a description of the
type of network of participating providers used by such
plan or coverage, and, in the case of a group health
plan, a description of whether such plan is self-
insured or fully-insured.
``(D) For each item or service which is paid as
part of a bundled or capitated rate--
``(i) a description of the formulae,
pricing methodologies, or other information
used to calculate the payment rate for such
rate; and
``(ii) a list of the items and services
included in such rate.
``(E) The percentage of items and services that are
paid for on a fee-for-service basis and the percentage
of items and services that are paid for as part of a
bundled rate, capitated payment rate, or other
alternative payment model.
``(d) Attestation.--Each group health plan and health insurance
issuer offering group or individual health insurance coverage shall
annually submit to the Secretary an attestation of such plan's or
coverage's compliance with the provisions of this section. Such
attestation shall include a link to the website (or other successor
technology) where rate and payment information required to be made
public under subsection (c) may be accessed.
``(e) Accessibility.--A group health plan and a health insurance
issuer offering group or individual health insurance coverage shall
take reasonable steps (as specified by the Secretary) to ensure that
information provided in response to a request described in subsection
(b), and rate and payment information made public under subsection (c),
is provided in plain, easily understandable language and that
interpretation, translations, and assistive services are provided to
those with limited English proficiency and those with disabilities.
``(f) PBM Disclosure of Applicable Spread Price Drugs.--An entity
providing pharmacy benefit management services on behalf of a group
health plan or group or individual health insurance coverage shall
disclose to such plan or coverage, at such time and in such manner as
specified by the Secretary to ensure that information provided under
subsection (b) and rate and payment information made public under
subsection (c) is timely and accurate--
``(1) a list of drugs (identified by national drug codes)
for which benefits are available under such plan that are
applicable spread price drugs; and
``(2) with respect to each drug included on such list and
each pharmacy with a contractual relationship for furnishing
such drug under such plan or coverage, a specification of the
difference (if any) between the specified payment amount for
such drug so dispensed by such pharmacy and the specified
reimbursement amount for such drug so dispensed by such
pharmacy.
``(g) Definitions.--In this section:
``(1) Applicable spread price drug.--The term `applicable
spread price drug' means, with respect to a group health plan
or group or individual health insurance coverage, a drug for
which benefits are available under such plan or coverage and
with respect to which, at the time a disclosure described in
subsection (f) is required to be made by an entity providing
pharmacy benefit management services on behalf of such plan or
coverage--
``(A) a contract is in effect between such entity
and a pharmacy for the dispensing of such drug under
such plan or coverage; and
``(B) the specified payment amount for such drug so
dispensed is less than the specified reimbursement
amount for such drug so dispensed.
``(2) In-network rate.--The term `in-network rate' means,
with respect to a group health plan or group or individual
health insurance coverage and an item or service furnished by a
provider that is a participating provider with respect to such
plan or coverage and item or service, the contracted rate
(reflected as a dollar amount) in effect between such plan or
coverage and such provider for such item or service, regardless
of whether such rate is calculated based on a set amount, a fee
schedule, or an amount derived from another amount, or a
formula, or other method.
``(3) Participating provider.--The term `participating
provider' means, with respect to an item or service and a group
health plan or health insurance issuer offering group or
individual health insurance coverage, a physician or other
health care provider (as defined in paragraph (4)) who is
acting within the scope of practice of that provider's license
or certification under applicable State law and who has a
contractual relationship with the plan or issuer, respectively,
for furnishing such item or service under the plan or coverage,
respectively.
``(4) Provider.--The term `provider' includes a health care
facility and a pharmacy.
``(5) Specified payment amount.--The term `specified
payment amount' means, with respect to a drug to be dispensed
by a pharmacy to a participant, beneficiary, or enrollee of a
group health plan or group or individual health insurance
coverage where such pharmacy has in effect a contract with an
entity providing pharmacy benefit management services on behalf
of such plan or coverage for the dispensing of such drug under
such plan or coverage, the amount that such entity has agreed
to pay such pharmacy for the ingredient costs and any
applicable dispensing fee for such drug (or the amount that
such entity has agreed to pay such pharmacy for such drug under
any other compensation structure specified by the Secretary)
under such contract, taking into account any cost sharing
requirement applicable to such drug and participant,
beneficiary, or enrollee.
``(6) Specified reimbursement amount.--The term `specified
reimbursement amount' means, with respect to a drug to be
dispensed by a pharmacy to a participant, beneficiary, or
enrollee of a group health plan or group or individual health
insurance coverage where such pharmacy has in effect a contract
with an entity providing pharmacy benefit management services
on behalf of such plan or coverage for the dispensing of such
drug under such plan or coverage, that amount that such plan or
coverage has agreed to pay to such entity for the ingredient
costs and any applicable dispensing fee for such drug (or the
amount that such plan or coverage has agreed to pay such entity
for such drug under any other compensation structure specified
by the Secretary), taking into account any cost sharing
requirement applicable to such drug and participant,
beneficiary, or enrollee.''.
(3) ERISA.--
(A) In general.--Section 719 of the Employee
Retirement Income Security Act of 1974 (29 U.S.C.
1185h) is amended--
(i) in the header, by striking
``maintenance of price comparison tool'' and
inserting ``transparency in coverage'';
(ii) by striking ``A group health plan''
and inserting the following:
``(a) Maintenance of Price Comparison Tool for Plan Years Before
2028.--
``(1) In general.--A group health plan'';
(iii) in subsection (a), as inserted by
clause (ii), by adding at the end the following
new paragraph:
``(2) Sunset.--Paragraph (1) shall not apply with respect
to plan years beginning on or after January 1, 2028.''; and
(iv) by adding at the end the following new
subsections:
``(b) Cost-Sharing Transparency.--
``(1) In general.--For plan years beginning on or after
January 1, 2028, a group health plan and a health insurance
issuer offering group health insurance coverage shall provide a
participant or beneficiary, in a timely manner upon request of
the participant or beneficiary, information on the amount of
cost-sharing (including deductibles, copayments, and
coinsurance) under the participant or beneficiary's plan or
coverage that the participant or beneficiary would be
responsible for paying with respect to the furnishing of a
specific item or service by a provider. At a minimum, such
information shall include the information specified in
paragraph (2) and shall be made available to such participant
or beneficiary through a self-service tool that meets the
requirements of paragraph (3) or, at the option of such
participant or beneficiary, through a paper disclosure or phone
or other electronic disclosure (as selected by such participant
or beneficiary and provided at no cost to such participant or
beneficiary) that meets such requirements as the Secretary may
specify.
``(2) Specified information.--For purposes of paragraph
(1), the information specified in this paragraph is, with
respect to an item or service for which benefits are available
under a group health plan or group health insurance coverage
furnished by a health care provider to a participant or
beneficiary of such plan or coverage, the following:
``(A) If such provider is a participating provider
with respect to such item or service, the in-network
rate for such item or service.
``(B) If such provider is not a participating
provider with respect to such item or service, the
maximum allowed amount or other dollar amount that such
plan or coverage will recognize as payment for such
item or service, along with a notice that such
participant or beneficiary may be liable for additional
charges.
``(C) The estimated amount of cost-sharing
(including deductibles, copayments, and coinsurance)
that the participant or beneficiary will incur for such
item or service (which, in the case such item or
service is to be furnished by a provider described in
subparagraph (B), shall be calculated using the maximum
allowed amount or other dollar amount described in such
subparagraph).
``(D) The amount the participant or beneficiary has
already accumulated with respect to any deductible or
out of pocket maximum under the plan or coverage
(broken down, in the case separate deductibles or
maximums apply to a participant and such participant's
beneficiaries enrolled in the plan or coverage, by such
separate deductibles or maximums, in addition to any
cumulative deductible or maximum).
``(E) In the case such plan imposes any frequency
or volume limitations with respect to such item or
service (excluding medical necessity determinations),
the amount that such participant or beneficiary has
accrued towards such limitation with respect to such
item or service.
``(F) Any prior authorization, concurrent review,
step therapy, fail first, or similar requirements
applicable to coverage of such item or service under
such plan or coverage.
``(G) Any financial incentives (such as any credit,
payment, or other benefit provided by such plan or
issuer) available to the participant or beneficiary
with respect to such item or service furnished by such
provider known at the time such request is made.
``(H) In the case such item or service is an
applicable spread price drug dispensed by a pharmacy--
``(i) a specification that such item or
service is such an applicable spread price
drug;
``(ii) the amount of the difference (if
any) between the specified payment amount for
such drug so dispensed by such pharmacy and the
specified reimbursement amount for such drug so
dispensed by such pharmacy;
``(iii) a plain language statement
specified by the Secretary that explains the
concept of spread pricing and how such item's
status as such an applicable spread price drug
may impact the amount such plan or coverage
pays for such drug and cost sharing amounts for
such drug described in subparagraph (C); and
``(iv) a plain language statement specified
by the Secretary informing the participant or
beneficiary of the participant's or
beneficiary's ability to obtain a summary
document relating to drug pricing information
described in section 726(b)(2)(B)(ii).
``(3) Self-service tool.--For purposes of paragraph (1), a
self-service tool established by a group health plan or health
insurance issuer offering group health insurance coverage meets
the requirements of this paragraph if such tool--
``(A) is based on an internet website (or successor
technology specified by the Secretary);
``(B) provides for real-time responses to requests
described in paragraph (1);
``(C) is updated in a manner such that information
provided through such tool is timely and accurate at
the time such request is made;
``(D) allows such a request to be made with respect
to an item or service furnished by--
``(i) a specific provider that is a
participating provider with respect to such
item or service;
``(ii) all providers that are participating
providers with respect to such item or service;
or
``(iii) a provider located in a relevant
geographic region that is not a participating
provider with respect to such item or service;
``(E) provides that such a request may be made with
respect to an item or service through use of the
billing code for such item or service or through use of
a descriptive term for such item or service; and
``(F) meets any other requirement determined
appropriate by the Secretary, including requirements to
ensure the accessibility and usability of information
provided through such tool.
The Secretary may require such tool, as a condition of
complying with subparagraph (E), to link multiple billing codes
to a single descriptive term if the Secretary determines that
the billing codes to be so linked correspond to similar items
and services.
``(c) Rate and Payment Information.--
``(1) In general.--For plan years beginning on or after
January 1, 2028, each group health plan and health insurance
issuer offering group health insurance coverage (other than a
grandfathered health plan (as defined in section 1251(e) of the
Patient Protection and Affordable Care Act)) shall make
available to the public the rate and payment information
described in paragraph (2) in accordance with paragraph (3).
``(2) Rate and payment information described.--For purposes
of paragraph (1), the rate and payment information described in
this paragraph is, with respect to a group health plan or group
health insurance coverage, the following:
``(A) With respect to each item or service (other
than a drug) for which benefits are available under
such plan or coverage--
``(i) the in-network rate (expressed as a
dollar amount) in effect as of the date on
which such information is made public with each
provider that is a participating provider with
respect to such item or service;
``(ii) with respect to each such provider,
an indication of whether, during the 1-year
period beginning 18 months before the date such
information is made public, such provider
submitted a claim for such item or service to
such plan or coverage; and
``(iii) in the case that such plan or
coverage provides benefits for such item or
service only when furnished by a specific type
of provider, a specification of each type of
provider that may furnish such item or service
under such plan or coverage;
``(B) With respect to each drug (identified by
national drug code) for which benefits are available
under such plan or coverage--
``(i) the in-network rate (expressed as a
dollar amount) in effect as of the first day of
the month in which such information is made
public with each provider that is a
participating provider with respect to such
drug;
``(ii) the average amount paid by such plan
or coverage (accounting for, in a manner
determined appropriate by the Secretary,
rebates, discounts, price concessions, and any
other remuneration specified by the Secretary)
for such drug dispensed or administered during
the 90-day period beginning 180 days before
such date of publication to each provider that
was a participating provider with respect to
such drug, broken down by each such provider,
unless fewer than 20 claims for such drug were
submitted to such plan or coverage during such
period; and
``(iii) in the case such drug is an
applicable spread price drug dispensed by a
pharmacy--
``(I) a specification that such
drug is such an applicable spread price
drug; and
``(II) for each pharmacy that has a
contractual relationship for dispensing
such drug under such plan or coverage,
a specification of the difference (if
any) between the specified payment
amount for such drug so dispensed by
such pharmacy and the specified
reimbursement amount for such drug so
dispensed by such pharmacy.
``(C) With respect to each item or service for
which benefits are available under such plan or
coverage, the amount billed, and the amount allowed by
the plan, for each such item or service furnished
during the 6-month period beginning 9 months before the
date such information is made public by a provider that
was not a participating provider with respect to such
item or service, broken down by each such provider,
other than such an amount with respect to an item or
service furnished by a provider that, during such
period, submitted fewer than 11 claims for such item or
service to such plan or coverage.
``(3) Manner of publication.--
``(A) In general.--Rate and payment information
required to be made available under this subsection
shall be so made available in dollar amounts through
separate machine-readable files (and any successor
technology, as applicable, such as application
programming interface technology, determined
appropriate by the Secretary) corresponding to the
information described in each of subparagraphs (A)
through (C) of paragraph (2) that meet such
requirements as specified by the Secretary (which may
be so specified through subregulatory guidance). Such
requirements shall ensure that such files are limited
to an appropriate size, do not include disclosure of
unnecessary duplicative information contained in other
files made available under this subsection, are made
available in a widely available format through a
publicly available website that allows for information
contained in such files to be compared across group
health plans and group or individual health insurance
coverage, and are accessible to individuals at no cost
and without the need to establish a user account or
provide other credentials.
``(B) Timing.--Rate and payment information--
``(i) described in subparagraph (A) or (B)
of paragraph (2) shall be made public on a
quarterly basis; and
``(ii) described in subparagraph (C) of
paragraph (2) shall be made public on a monthly
basis.
``(4) User instructions.--Each group health plan and health
insurance issuer offering group health insurance coverage shall
make available to the public instructions written in plain
language explaining how individuals may search for information
described in paragraph (2) in files submitted in accordance
with paragraph (3). The Secretary shall develop and publish
through subregulatory guidance a template that such a plan may
use in developing instructions for purposes of the preceding
sentence.
``(5) Summary.--For each plan year beginning on or after
January 1, 2028, each group health plan and health insurance
issuer offering group health insurance coverage shall make
public a data file, in a manner that ensures that such file may
be easily downloaded and read by standard spreadsheet software
and that meets such requirements as established by the
Secretary, containing a summary of all rate and payment
information made public by such plan or issuer with respect to
such plan or coverage during such plan year. Such file shall
include the following:
``(A) The mean, median, and interquartile range of
the in-network rate, and the amount allowed for an item
or service when not furnished by a participating
provider, in effect as of the first day of such plan
year for each item or service (identified by payer
identifier approved or used by the Centers for Medicare
& Medicaid Services) for which benefits are available
under the plan or coverage, broken down by the type of
provider furnishing the item or service and by the
geographic area in which such item or service is
furnished.
``(B) Trends in payment rates for such items and
services over such plan year, including an
identification of instances in which such rates have
increased, decreased, or remained the same.
``(C) The name of such plan, a description of the
type of network of participating providers used by such
plan or coverage, and, in the case of a group health
plan, a description of whether such plan is self-
insured or fully-insured.
``(D) For each item or service which is paid as
part of a bundled or capitated rate--
``(i) a description of the formulae,
pricing methodologies, or other information
used to calculate the payment rate for such
rate; and
``(ii) a list of the items and services
included in such rate.
``(E) The percentage of items and services that are
paid for on a fee-for-service basis and the percentage
of items and services that are paid for as part of a
bundled rate, capitated payment rate, or other
alternative payment model.
``(d) Attestation.--Each group health plan and health insurance
issuer offering group health insurance coverage shall annually submit
to the Secretary an attestation of such plan's or coverage's compliance
with the provisions of this section. Such attestation shall include a
link to the website (or other successor technology) where rate and
payment information required to be made public under subsection (c) may
be accessed.
``(e) Accessibility.--A group health plan and a health insurance
issuer offering group health insurance coverage shall take reasonable
steps (as specified by the Secretary) to ensure that information
provided in response to a request described in subsection (b), and rate
and payment information made public under subsection (c), is provided
in plain, easily understandable language and that interpretation,
translations, and assistive services are provided to those with limited
English proficiency and those with disabilities.
``(f) PBM Disclosure of Applicable Spread Price Drugs.--An entity
providing pharmacy benefit management services on behalf of a group
health plan or group health insurance coverage shall disclose to such
plan or coverage, at such time and in such manner as specified by the
Secretary to ensure that information provided under subsection (b) and
rate and payment information made public under subsection (c) is timely
and accurate--
``(1) a list of drugs (identified by national drug codes)
for which benefits are available under such plan that are
applicable spread price drugs; and
``(2) with respect to each drug included on such list and
each pharmacy with a contractual relationship for furnishing
such drug under such plan or coverage, a specification of the
difference (if any) between the specified payment amount for
such drug so dispensed by such pharmacy and the specified
reimbursement amount for such drug so dispensed by such
pharmacy.
``(g) Definitions.--In this section:
``(1) Applicable spread price drug.--The term `applicable
spread price drug' means, with respect to a group health plan
or group health insurance coverage, a drug for which benefits
are available under such plan or coverage and with respect to
which, at the time a disclosure described in subsection (f) is
required to be made by an entity providing pharmacy benefit
management services on behalf of such plan or coverage--
``(A) a contract is in effect between such entity
and a pharmacy for the dispensing of such drug under
such plan or coverage; and
``(B) the specified payment amount for such drug so
dispensed is less than the specified reimbursement
amount for such drug so dispensed.
``(2) In-network rate.--The term `in-network rate' means,
with respect to a group health plan or group health insurance
coverage and an item or service furnished by a provider that is
a participating provider with respect to such plan or coverage
and item or service, the contracted rate (reflected as a dollar
amount) in effect between such plan or coverage and such
provider for such item or service, regardless of whether such
rate is calculated based on a set amount, a fee schedule, or an
amount derived from another amount, or a formula, or other
method.
``(3) Participating provider.--The term `participating
provider' means, with respect to an item or service and a group
health plan or health insurance issuer offering group health
insurance coverage, a physician or other health care provider
(as defined in paragraph (4)) who is acting within the scope of
practice of that provider's license or certification under
applicable State law and who has a contractual relationship
with the plan or issuer, respectively, for furnishing such item
or service under the plan or coverage, respectively.
``(4) Provider.--The term `provider' includes a health care
facility and a pharmacy.
``(5) Specified payment amount.--The term `specified
payment amount' means, with respect to a drug to be dispensed
by a pharmacy to a participant or beneficiary of a group health
plan or group health insurance coverage where such pharmacy has
in effect a contract with an entity providing pharmacy benefit
management services on behalf of such plan or coverage for the
dispensing of such drug under such plan or coverage, the amount
that such entity has agreed to pay such pharmacy for the
ingredient costs and any applicable dispensing fee for such
drug (or the amount that such entity has agreed to pay such
pharmacy for such drug under any other compensation structure
specified by the Secretary) under such contract, taking into
account any cost sharing requirement applicable to such drug
and participant or beneficiary.
``(6) Specified reimbursement amount.--The term `specified
reimbursement amount' means, with respect to a drug to be
dispensed by a pharmacy to a participant or beneficiary of a
group health plan or group health insurance coverage where such
pharmacy has in effect a contract with an entity providing
pharmacy benefit management services on behalf of such plan or
coverage for the dispensing of such drug under such plan or
coverage, that amount that such plan or coverage has agreed to
pay to such entity for the ingredient costs and any applicable
dispensing fee for such drug (or the amount that such plan or
coverage has agreed to pay such entity for such drug under any
other compensation structure specified by the Secretary),
taking into account any cost sharing requirement applicable to
such drug and participant or beneficiary.''.
(B) Clerical amendment.--The table of contents in
section 1 of the Employee Retirement Income Security
Act of 1974 is amended by striking the item relating to
section 719 and inserting the following new item:
``Sec. 719. Transparency in coverage.''.
(b) Application Programming Interface Report.--Not later than
January 1, 2028, and annually thereafter, the Secretary of Health and
Human Services shall, in consultation with the Office of the National
Coordinator for Health Information Technology, Department of Labor, the
Department of the Treasury, and stakeholders, submit to the House
Committees on Education and the Workforce, Energy and Commerce, and
Ways and Means, and the Senate Committees on Finance and Health,
Education, Labor, and Pensions a report on the use of standards-based
application programming interfaces (in this subsection referred to as
``APIs'') to facilitate access to health care price transparency
information and the interoperability of other medical information. Such
report shall include an evaluation of the capacity of the Department of
Health and Human Services, the Department of Labor, and the Department
of the Treasury to regulate and implement standards related to APIs and
recommendations for improving such capacity. Such report shall include
the following:
(1) A description of current use, and proposed use, of APIs
under Federal rules to facilitate interoperability, including
information related to capacity constraints within the
agencies, barriers to adoption, privacy and security,
administrative burdens and efficiencies, care coordination, and
levels of compliance.
(2) A description of the feasibility of agency
participation in the development of APIs to enable application
access to price transparency data under the amendments made by
subsection (a).
(3) A specification of the timeline for which such data
standards can be required to make such data accessible via an
API.
(4) An analysis of the benefits and challenges of
implementing standards-based APIs for price transparency data,
including the ability for consumers to access rate and payment
information and the amount of cost-sharing (including
deductibles, copayments, and coinsurance) under the consumer's
plan through third-party internet-based tools and applications.
(5) An analysis of the impact that APIs which provide real-
time access to pricing and cost-sharing information may have in
increasing the amount of services shoppable for individuals,
such as by standardizing more health care spend via episode
bundles.
(6) An analysis of which health care items and services may
be useful under API, such as those for which prices change with
the greatest frequency.
(7) An analysis of the cost of API standards implementation
on issuers, employers, and other private-sector entities.
(8) An analysis of the ability of State regulators to
enforce API standards and the costs to the Federal Government
and States to regulate and enforce API standards.
(9) An analysis of the interaction with API standards and
Federal health information privacy standards.
(c) Provider Tool Report.--
(1) In general.--Not later than 1 year after the date of
the enactment of this Act, The Secretary of Health and Human
Services, acting through the Administrator of the Centers for
Medicare & Medicaid Services, shall, in consultation with
stakeholders, conduct a study and submit to the House
Committees on Education and the Workforce, Energy and Commerce,
and Ways and Means, and the Senate Committees on Finance and
Health, Education, Labor, and Pensions a report on the
usefulness and feasibility of the establishment of a provider
tool by a group health plan, or a health insurance issuer
offering group or individual health insurance coverage, in
facilitating the provision of information made available
pursuant to the amendments made by subsection (a). Such report
shall include the following:
(A) A description of the feasibility of
establishing a requirement for the various types of
plans and coverage to offer such a provider tool,
including any challenges to establishing a provider
tool using the same technology platform as the self-
service tool described in such amendments.
(B) An evaluation on the usefulness of a provider
tool to aid patient-decision making and how such tool
would coordinate with other information available to a
patient and their provider under other Federal
requirements in place or under consideration.
(C) An evaluation of whether the information
provided by such tool would be duplicative of the
advanced explanation of benefits required under Federal
law or any other existing requirement.
(D) A description of the usability and expected
utilization of such tool among providers, including
among different provider types.
(E) An analysis of the impact of a provider tool in
value-based care arrangements.
(F) An analysis on the potential impact of the
provider tool on--
(i) patients' out-of-pocket spending;
(ii) plan design, including impacts on
cost-sharing requirements;
(iii) care coordination and quality;
(iv) plan premiums;
(v) overall health care spending and
utilization; and
(vi) health care access in rural areas.
(G) An analysis of the feasibility of a provider
tool to include additional functionality to facilitate
and improve the administration of the requirements on
providers to submit notifications to such plan or
coverage under section 2799B-6 of the Public Health
Service Act and the requirements on such plan or
coverage to provide an advanced explanation of benefits
to individuals under section 2799A-1(f) of such Act.
(H) An analysis of which health care items and
services, would be most useful for providers utilizing
a provider tool.
(I) An analysis of rulemaking required to ensure
such a tool complies with federal health information
privacy standards.
(J) An analysis of the burden and cost of the
creation of a provider tool by plans and coverage on
providers, issuers, employers, and other private-sector
entities.
(K) An analysis of the ability of state regulators
to enforce provider tool standards and the costs to the
Department and states to regulate and enforce provider
tool standards.
(2) Definition.--The term ``provider tool'' means a tool
designed to facilitate the provision of information made
available pursuant to the amendments made by subsection (a) and
established by a group health plan or a health insurance issuer
offering group or individual health insurance coverage that
allows providers to access the information such plan or
coverage must provide through the self-service tool described
in such amendments to an individual with whom the provider is
actively treating at the time of such request, upon the request
of the provider, and with the consent of such individual.
(d) Reports.--
(1) Compliance.--Not later than January 1, 2029, the
Comptroller General of the United States shall submit to
Congress a report containing--
(A) an analysis of compliance with the amendments
made by this section;
(B) an analysis of enforcement of such amendments
by the Secretaries of Health and Human Services, Labor,
and the Treasury;
(C) recommendations relating to improving such
enforcement; and
(D) recommendations relating to improving public
disclosure, and public awareness, of information
required to be made available by group health plans and
health insurance issuers pursuant to such amendments.
(2) Prices.--Not later than January 1, 2029, and biennially
thereafter, the Secretaries of Health and Human Services,
Labor, and the Treasury shall jointly submit to Congress a
report containing an assessment of differences in negotiated
prices (and any trends in such prices) in the private market
between--
(A) rural and urban areas;
(B) the individual, small group, and large group
markets;
(C) consolidated and nonconsolidated health care
provider areas (as specified by the Secretary of Health
and Human Services);
(D) nonprofit and for-profit hospitals;
(E) nonprofit and for-profit insurers; and
(F) insurers serving local or regional areas and
insurers serving multistate or national areas.
(e) Quality Report.--Not later than 1 year after the date of
enactment of this subsection, the Secretaries of Health and Human
Services, Labor, and the Treasury shall jointly submit to Congress a
report on the feasibility of including data relating to the quality of
health care items and services with the price transparency information
required to be made available under the amendments made by subsection
(a). Such report shall include recommendations for legislative and
regulatory actions to identify appropriate metrics for assessing and
comparing quality of care.
(f) Continued Applicability of Rules for Previous Years.--Nothing
in the amendments made by subsection (a) may be construed as affecting
the applicability of the rule entitled ``Transparency in Coverage''
published by the Department of the Treasury, the Department of Labor,
and the Department of Health and Human Services on November 12, 2020
(85 Fed. Reg. 72158), for any plan year beginning before January 1,
2028.
<all>Official legislative text sourced from the public record (cached on CivicsHQ).
Official source
View the original bill, actions, and full legislative record on Congress.gov.
Status
In Committee
- 1Introduced
- 2Committee
- 3Floor
- 4Passed
- 5Signed
Timeline reflects current normalized status only. Full action history is not yet stored in the API.
Sponsors
- Rep. Guthrie, Brett [R-KY-2]RHouseKY
Cosponsors
Votes
Voting records are not yet available for this bill.