Sponsor
Jason Smith
Representative · R-MO
Representative · R-MO
The bill substantially expands price transparency and consumer tools—improving patients' ability to compare and budget for care and enabling oversight—but does so at the cost of large compliance, technical, privacy, and enforcement burdens that could raise provider/plan costs, strain smaller and rural providers, and produce unintended market effects.
Patients (including Medicare, Medicaid, uninsured, low‑income, and people with chronic conditions) gain standardized, item‑level price and real‑time out‑of‑pocket estimates plus consumer price‑estimator tools so they can compare costs, plan care, and reduce surprise bills.
People with limited English proficiency, low digital literacy, and people with disabilities get improved access via plain‑language tools, telephone help, and accessibility requirements so price information is more equitable and usable.
CMS and federal agencies will publish standardized, machine‑readable price/negotiated‑rate data, APIs, and aggregated analyses, enabling oversight, research, third‑party price‑comparison tools, and better policy-making.
Hospitals, providers, plans, PBMs, pharmacies, and labs face substantial compliance, data‑collection, IT, and reporting costs (including building real‑time tools and APIs) that could be passed to patients or reflected in higher premiums and could divert staff/time from patient care.
Public disclosure of negotiated in‑network rates, payer‑specific negotiated charges, and transactional data risks exposing commercially sensitive information, complicating payer‑provider negotiations, prompting litigation, or enabling tacit price coordination with uncertain effects on prices.
Detailed, machine‑readable, claim‑level datasets and real‑time APIs increase privacy and data‑security risks where deidentification or protections fail, which could expose sensitive patient information or require costly safeguards.
Based on analysis of 8 sections of legislative text.
Expands mandatory price disclosures and consumer cost tools across hospitals, ASCs, group health plans, insurers, PBMs, and Medicare Advantage/Part D sponsors, with reporting, penalties, and federal implementation funding.
Official title: To promote health care price transparency, and for other purposes.
Introduced July 13, 2026 by Jason Smith · Last progress July 13, 2026
Requires hospitals, ambulatory surgical centers, group health plans, health insurers, pharmacy benefit managers, Medicare Advantage organizations, and Part D sponsors to disclose standardized price and charge information in consumer‑friendly and machine‑readable formats and to provide real‑time consumer cost tools. Creates new reporting, enforcement, penalty, accessibility, and anti‑retaliation rules; phases in hospital requirements starting January 1, 2027 and group plan/insurer requirements for plan years beginning January 1, 2029; and provides federal implementation funding for HHS, Treasury, and Labor.