Washington, D.C. — U.S. Senator Susan Collins, the Chairman of the Aging Committee and a member of the Health Committee, cosponsored the Health Care PRICE Transparency Act, legislation that would codify two health care price transparency rules that require hospitals and insurers to reveal their discounted cash prices and negotiated rates to consumers before they receive medical care. The legislation was also introduced by Senators Mike Braun (R-IN),Chuck Grassley (R-IA), Joni Ernst (R-IA), Mike Enzi (R-WY), John Kennedy (R-LA), Kelly Loeffler (R-GA), and John Barrasso (R-WY).
“With our nation facing a health and economic crisis, it is more important than ever that Congress come together to increase health care affordability and accessibility,” said Senator Collins. “I can’t think of any other service Americans buy where the price is more opaque than health care. By strengthening transparency, this commonsense legislation would help increase competition among providers and ensure consumers pay the lowest possible price for medical care.”
Last November, the Administration issued two rules to increase price transparency, empower patients, and increase competition among all hospitals and insurers. The hospital price transparency rule, which is set to go into effect in January 2021, was immediately challenged in court. In June, a federal judge sided with the Administration and upheld the legality of the hospital transparency rule. With additional legal challenges expected, the Health Care PRICE Transparency Act would codify these rules to overcome these challenges and allow patients to make cost conscious health care decisions.
The Health Care PRICE Transparency Act would require hospitals to:
- Provide patients with clear, accessible information about their "standard charges" for the items and services they provide, including through the use of standardized data elements, making it easier to shop and compare across hospitals, as well as mitigating surprises;
- Make public all hospital standard charges (including the gross charges, negotiated rates and charges, the amount the hospital is willing to accept in cash from a patient) for all items and services on the Internet in a single data file that can be read by other computer systems (i.e., machine readable format); and.
- Make public negotiated rates and charges, cash prices, etc. in a manner that is consumer-friendly and up-to-date.
The Health Care PRICE Transparency Act would require insurers to:
- Give consumers real-time, personalized access to cost-sharing information—including an estimate of their cost-sharing liability for all covered health care items and services;
- Publish this information online and available to all of their beneficiaries, and in paper form, at the beneficiaries’ request – empowering consumers to shop and compare costs between specific providers before receiving care; and,
- Disclose on a public website their negotiated rates for in-network providers and allowed amounts paid for out-of-network providers.