Sponsor
Warren Davidson
Representative · R-OH
Representative · R-OH
The bill increases price transparency so patients can better anticipate and compare health care costs, but it shifts administrative, compliance, and potential legal burdens onto hospitals, insurers, and payers—risks that may raise costs or strain providers, especially smaller and rural facilities.
Patients (including those with chronic conditions, uninsured people, and Medicaid beneficiaries) gain searchable, no‑signup price estimators and standardized published price data so they can see expected out‑of‑pocket costs, compare providers, and face fewer surprise bills.
Hospitals and state governments operate under clear, uniform definitions and minimum reporting standards, making published price information more comparable and reducing variability in how data are presented.
Hospitals are subject to financial penalties for noncompliance, creating stronger enforcement incentives that increase the likelihood of timely, accurate price disclosures for consumers.
Hospitals—particularly smaller and rural facilities—must bear upfront IT and administrative costs to build and maintain estimator tools and publish detailed data, straining limited budgets.
Insurers and PBMs will incur costs to compile and provide granular negotiated‑rate and historical price data; those compliance costs could be passed on to enrollees through higher premiums or plan costs.
Hospitals risk ongoing fines (up to $300/day) during compliance delays, which could worsen financial strain and potentially reduce funds available for patient care.
Based on analysis of 2 sections of legislative text.
Requires hospitals to publish expanded standardized price data and maintain a free online price estimator with patient-specific out-of-pocket estimates for at least 300 shoppable services.
Official title: To amend the Public Health Service Act to provide for hospital and insurer price transparency.
Introduced January 9, 2025 by Warren Davidson · Last progress January 9, 2025
Requires hospitals to publish expanded, standardized price information and to offer a publicly accessible online price estimator that provides patient-specific out-of-pocket estimates for a required set of at least 300 "shoppable" services (or all shoppable services the hospital provides if fewer). Establishes definitions for posted charge elements, enumerates required data fields, and creates civil monetary penalties (up to $300/day) for noncompliance unless the hospital has an approved corrective action plan.