Bill > HR5582

This bill, titled the "Patients Deserve Price Tags Act," comprehensively aims to increase transparency in healthcare pricing across multiple sectors. The bill requires hospitals, clinical diagnostic laboratories, imaging services, and ambulatory surgical centers to publicly disclose detailed pricing information, including gross charges, discounted cash prices, and negotiated rates with different payers. Starting in 2026-2027, these healthcare providers must publish machine-readable spreadsheets with pricing information for at least 300 shoppable services, making it easier for consumers to understand and compare healthcare costs. The bill also mandates that health insurance plans provide more detailed explanations of benefits, including specific cost-sharing amounts, billing codes, and provider participation status. Additionally, the legislation introduces enforcement mechanisms with significant financial penalties for non-compliance, ranging from $300 to $10,000 per day depending on the type and size of the healthcare provider. The bill does not supersede existing state laws on price transparency and allows for technical assistance to help providers meet the new requirements. The overarching goal is to increase healthcare price transparency, help patients make more informed healthcare decisions, and potentially reduce unexpected medical costs.

Business and Industry

https://www.congress.gov/bill/119th-congress/house-bill/5582/all-info