The Patients Right to Save Act introduces significant cost control measures for health care services in Iowa, focusing on transparency and affordability. The bill mandates that health care providers disclose the discounted cash price for specific services when paid in cash, ensuring this information is available to both covered persons and uninsured individuals. Providers are required to review these prices annually and inform individuals of their right to pay via the discounted cash price prior to scheduled services. Additionally, the bill prohibits contracts that restrict providers from offering discounted cash prices below contracted rates, thereby promoting competitive pricing.

The legislation also establishes a framework for health benefit plans to disclose the average allowed amount for covered services, ensuring that individuals who choose discounted cash prices below this average receive credit toward their cost-sharing obligations. A savings incentive program is introduced to reward individuals for utilizing discounted cash prices, with shared savings between the individual and their health benefit plan. The bill further mandates that pharmacists have access to out-of-pocket pricing through a secure online platform and prohibits discrimination in payment for in-network services based on referrals from out-of-network providers. The Department of Administrative Services is tasked with analyzing the cost-effectiveness of these programs for state employees, with a report due by September 1, 2026, and potential implementation for the 2027 state employee health insurance open enrollment period.

Statutes affected:
Introduced: 507B.4