Sponsors (22)
The bill greatly expands price and payment transparency and consumer protections—helping patients compare costs and access cash‑price options—while imposing substantial technical, administrative, and enforcement burdens on providers, plans, and vendors that could be passed on to consumers and disproportionately stress small or rural providers.
Most patients (including those with chronic conditions, Medicare/Medicaid beneficiaries, uninsured and low-income individuals) get clearer, timely, itemized EOBs, binding good‑faith cost estimates, and real‑time individualized price tools so they can see expected provider charges and their estimated out‑of‑pocket responsibility before receiving care.
Uninsured and self‑pay patients (and other cash payers) can find and pay published discounted or minimum cash prices for hospital services, labs, imaging, and ambulatory surgical center procedures, reducing surprise bills and lowering out‑of‑pocket costs for people who pay cash.
Standardized, machine‑readable price and rate files and public posting requirements enable third‑party tools, market comparability, stronger enforcement, and data‑driven policymaking that help consumers shop and policymakers monitor pricing across providers and payers.
Health plans, hospitals, providers, labs, ASCs, PBMs and vendors face substantial administrative, IT, and compliance costs to produce code‑level itemized bills, machine‑readable files, real‑time tools, and attestations — costs that are often passed to consumers through higher premiums, charges, or reduced services.
Small and rural hospitals, small providers, independent labs, ASCs, and small vendors bear disproportionate operational strain and financial risk (including per‑day fines), which could reduce local service availability or force closures in underserved communities.
Mandatory disclosure of payer‑specific negotiated rates, pricing formulas, and reconciliation rules may reveal commercially sensitive contract terms, trigger payer/provider renegotiation or legal disputes, and in some cases push negotiated prices higher for insured patients.
Based on analysis of 11 sections of legislative text.
Mandates standardized, itemized price and billing disclosures across insurers, providers, hospitals, labs, imaging centers, ASCs, and vendors and expands permitted data sharing with penalties for noncompliance.
Introduced July 17, 2025 by Roger Wayne Marshall · Last progress July 17, 2025
Requires insurers, providers, hospitals, labs, imaging centers, ambulatory surgical centers, and health-plan service vendors to publish clear, itemized price information and billing codes, provide detailed good-faith estimates and explanation-of-benefits notices, and share claims/payment data with plans under strict privacy safeguards. Establishes standardized machine-readable formats, acceptance of disclosed cash prices as payment in full for self-pay patients, civil penalties for noncompliance, and staged implementation dates for different provider types.