Sponsors (2)
The bill greatly expands price and payment transparency — giving patients clearer, often real-time cost information and enabling market oversight — but does so at the cost of substantial compliance burdens, disclosure risks, and potential strain on smaller or rural providers that could raise prices or reduce access.
Patients and plan enrollees (including Medicare and Medicaid beneficiaries) will get member-specific, real-time, itemized out-of-pocket cost estimates before receiving care, helping them plan and avoid surprise bills.
Consumers — including Medicare beneficiaries and uninsured or cash-paying patients — can see standardized discounted cash prices or gross charges for hospitals, lab tests, and imaging, making it easier to compare costs and potentially lower out-of-pocket spending.
Public, machine-readable rate and payment files will improve market oversight and let researchers, employers, regulators, and plan sponsors compare plans, detect pricing trends, and negotiate better rates.
Hospitals, labs, imaging suppliers, health plans, PBMs, and employers face substantial new administrative and IT compliance costs to collect, standardize, and publish the required data — costs that may be passed to consumers as higher prices or premiums.
Smaller and rural providers and labs may struggle to meet technical and reporting requirements, face daily civil penalties, and could divert resources from care or reduce local service availability.
Public disclosure of negotiated in‑network rates and PBM-specified payments can expose proprietary contract terms, prompting legal disputes, contract renegotiations, provider pushback, and potential market disruption.
Based on analysis of 7 sections of legislative text.
Requires hospitals, ASCs, labs, imaging providers, and group health plans to publish standardized, consumer- and machine-readable prices and member-specific out-of-pocket estimates beginning Jan 1, 2028, with penalties for noncompliance.
Official title: To promote price transparency in the health care sector.
Introduced June 23, 2026 by Brett Guthrie · Last progress June 23, 2026
Requires hospitals, ambulatory surgical centers, clinical laboratories, imaging providers, and group health plans/issuers to publish standardized, consumer-facing and machine-readable price and out-of-pocket cost data beginning January 1, 2028. Sets uniform formats and accessibility standards, requires attestation of accuracy, creates monitoring and notice procedures, and authorizes civil monetary penalties for noncompliance; agencies must issue implementation rules and provide technical assistance.