H.R. 3020

119th CONGRESS 1st Session

To require the Government Accountability Office to evaluate the effects of anticompetitive contracting clauses in contracts between health insurers and health care providers and to determine actions taken by the Federal Trade Commission and the Department of Justice relating to the use of such clauses in such contracts and to assess their ability to effectively enforce the Federal antitrust laws with respect to such use.

IN THE HOUSE OF REPRESENTATIVES · April 24, 2025 · Sponsor: Mrs. Spartz

Table of contents

• H.R. 3020
  • SEC. 1. Short title
  • SEC. 2. GAO study
  • SEC. 3. Definitions

SEC. 1. Short title

• This Act may be cited as the Addressing Anti-Competitive Health Care Contract Clauses Act.

SEC. 2. GAO study

• (a) Study
  • Not later than 18 months after the date of the enactment of this Act, the Comptroller General of the United States, in coordination with the Federal Trade Commission and the Assistant Attorney General of the Antitrust Division of the Department of Justice, shall carry out a study that—
    • evaluates the effect of anticompetitive contract clauses known as anti-steering clauses, anti-tiering clauses, all-or-nothing clauses, and gag clauses in contracts between health insurers and health care providers, including the effects such contracts have on consolidation in the health care industry, prices paid by consumers for medical services, and consumer access to health care,
    • contains a list of all actions the Federal Trade Commission and the Department of Justice have taken directly or indirectly related to use of such contract clauses in contracts between health insurers and health care providers,
    • contains an assessment of whether the Federal Trade Commission and the Department of Justice have the resources and the capability to effectively enforce the Federal antitrust laws as applied to the use of such clauses in such contracts, and
    • includes recommendations for legislative or administrative actions if necessary to increase such resources.
• (b) Report
  • The report containing the results of the study carried out under subsection (a) shall be submitted timely by the Comptroller General as follows:
    • To—
      • the Committee on Energy and Commerce,
      • the Committee on Ways and Means,
      • the Committee on Education and Workforce, and
      • the Committee on the Judiciary,
    • of the House of Representatives.
    • To—
      • The Committee on Health, Education, Labor, and Pensions, and
      • The Committee on the Judiciary,
    • of the Senate.

SEC. 3. Definitions

• For purposes of this Act:
  • The term all-or-nothing clause means a provision of a health care contract that requires—
  • The term anti-steering clause means a provision of a health care contract that restricts the ability of a health insurance carrier or a health plan administrator from encouraging an enrollee to obtain a health care service from a competitor of the hospital or health system, including offering incentives to encourage enrollees to utilize specific health care providers.
  • The term anti-tiering clause means a provision in a health care contract that—
  • The term gag clause means a provision of a health care contract that—
  • The term tiered network plan means a health benefit plan that sorts some or all types of health care providers into specific groups to which different provider reimbursement, enrollee cost sharing, health care provider access requirements, or a combination thereof, are applied for the same services.