H.R. 267 — Health Care PRICE Transparency Act

This section revises hospital price transparency requirements under the Public Health Service Act by requiring each hospital to make available, in plain language without subscription and free of charge in a consumer-friendly, machine-readable format, a list of standard charges that includes (1) a description of each item or service, (2) the gross charge, (3) any payer-specific negotiated charge, (4) the de-identified minimum and maximum negotiated charges, (5) the discounted cash price, and (6) applicable billing codes (e.g., CPT, HCPCS, DRG, NDC). It further requires hospitals to publicly disclose such information for at least 300 shoppable services (i.e., those that can be scheduled in advance), including all 70 CMS-specified shoppable services provided by the hospital (or all shoppable services if fewer than 300), either directly or via an internet-based price estimator tool that provides personalized cost estimates searchable by service, code, or payer without fees or personal information; it defines key terms (e.g., gross charge as the undiscounted chargemaster rate); and it authorizes civil monetary penalties of up to $300 per day for noncompliance. The section also amends requirements for American Health Benefit Exchanges under the Patient Protection and Affordable Care Act by requiring Exchanges to display (1) in-network provider rates for covered items and services, (2) out-of-network allowed amounts and billed charges for covered items and services, and (3) negotiated rates and historical net prices for covered prescription drugs.