Health Care PRICE Transparency Act

This bill aims to make health care prices clear before you get care. Hospitals must make public the prices they charge for at least 300 common, schedulable services (“shoppable services”). A hospital can meet this rule by offering a free, easy‑to‑find online price estimator that lets you see what you would owe; the tool must be reachable without logging in or giving personal info and be searchable by service, code, and insurer. Hospitals must also show key price types (like list price, cash price, and each insurer’s negotiated price) and common billing codes. Hospitals that don’t comply can be fined up to $300 per day.

Health insurance plans must publish their in‑network and out‑of‑network prices and reveal negotiated and historical net prices for prescription drugs. They must provide a web tool that gives real‑time estimates of what you’ll pay and, if you ask, mail a paper estimate within two business days. The tool must include helpful notes, like that estimates aren’t guarantees, out‑of‑network doctors may “balance bill,” and whether co‑pay assistance counts toward your deductible. These rules apply broadly, including to employer group plans (both self‑insured and fully insured).

• Who is affected: Patients, hospitals, health insurers, and group health plans.
• What changes: Up‑front price lists from hospitals and easy‑to‑use tools from hospitals and insurers to estimate your costs.
• When: Not specified in the provided text.