OHIO LEGISLATIVE SERVICE COMMISSION
Office of Research Legislative Budget
www.lsc.ohio.gov and Drafting Office
H.B. 173* Bill Analysis
135th General Assembly
Click here for H.B. 173’s Fiscal Note
Version: As Reported by Senate General Government
Primary Sponsor: Rep. Troy
Effective date:
Emily E. Wendel and Logan Briggs, Attorneys
SUMMARY
Special designations
▪ Designates the month of May as Older Ohioans Month.
▪ Designates the week that includes March 16 as Ohio Black Media Week.
Availability of hospital price information
▪ Requires each hospital to maintain and make public a list of all standard charges for all
hospital items or services.
▪ Also requires the hospital to maintain and make public a consumer-friendly list of
standard charges for at least 300 of the hospital’s shoppable services.
▪ Requires the list of standard charges for shoppable services to include the 70 services
specified as shoppable services by the United States Centers for Medicare and Medicaid
Services, or as many of those services as the hospital provides.
▪ Permits hospitals to fulfill the requirement for a list of standard charges for shoppable
services by providing a qualifying internet-based price estimator tool.
▪ Prohibits hospitals from selling the personal data of a person in this state acquired from
an internet-based price estimator tool.
▪ Prohibits hospitals from using, selling, or processing the personal data of a person in this
state acquired from an internet-based price estimator tool for the purposes of targeted
advertising.
* This analysis was prepared before the report of the Senate General Government Committee appeared
in the Senate Journal. Note that the legislative history may be incomplete.
December 17, 2024
Office of Research and Drafting LSC Legislative Budget Office
▪ Requires the Director of Health to monitor each hospital’s compliance with the bill’s
requirements and in cases of noncompliance, to impose penalties, including fines.
▪ Creates the Hospital Price Transparency Fund.
▪ Requires the Director to create a public list of hospitals not in compliance with the price
transparency requirements.
▪ Requires the Director to submit to the General Assembly and the Governor reports
regarding noncompliant hospitals, changes to the federal price transparency law, and
recommendations for changing state hospital price transparency requirements.
TABLE OF CONTENTS
Availability of hospital price information ....................................................................................... 1
Special designations ........................................................................................................................ 3
Availability of hospital price information ....................................................................................... 3
Overview...................................................................................................................................... 3
Definitions ................................................................................................................................... 4
Standard charges for hospital items and services ...................................................................... 5
Single digital file – machine readable format......................................................................... 6
List items ................................................................................................................................. 6
Hospital location ..................................................................................................................... 6
Standard charges for shoppable services ................................................................................... 6
Hospital selection of shoppable services ............................................................................... 6
List items ................................................................................................................................. 7
Price estimator tool ................................................................................................................ 7
Publication and updates .............................................................................................................. 8
Accessibility and formatting ................................................................................................... 8
Templates ............................................................................................................................... 8
Hospital website ..................................................................................................................... 9
Updates................................................................................................................................... 9
Director of Health duties ............................................................................................................. 9
Monitoring .............................................................................................................................. 9
List of noncompliant hospitals ............................................................................................... 9
Notice of violation and corrective action plan ..................................................................... 10
Administrative penalties....................................................................................................... 10
Reports ................................................................................................................................. 11
Background................................................................................................................................ 11
Hospital price information list – current law ....................................................................... 11
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Enforcement ......................................................................................................................... 12
CMS hospital price transparency rule .................................................................................. 12
DETAILED ANALYSIS
Special designations
Special Designations
Designation Date Other Information
Older Ohioans
The month of May n/a
Month1
Ohio Black Media Week that includes Recognizes the freedom of the press, information,
Week2 March 16 equity, and equality.
Availability of hospital price information
Overview
The bill directs each institution or facility that provides inpatient medical or surgical
services for a continuous period longer than 24 hours, i.e., a “hospital,” to maintain and make
public both of the following:
▪ A digital file in a machine-readable format that contains a list of all standard charges for
all hospital items and services;3
▪ Either a consumer-friendly list of standard charges for a limited set of “shoppable
services,” which are services that a health care consumer may schedule in advance, or an
internet-based price estimator tool.4
The bill repeals current law requiring every hospital to make available for public
inspection a price information list, which includes charges for certain hospital services. 5 Many of
the bill’s provisions closely mirror those in the hospital price transparency rule adopted by the
federal Centers for Medicare and Medicaid Services (CMS) and effective since January 1, 2021.
1 R.C. 5.2410.
2 R.C. 5.59.
3 R.C. 3727.32 and 3727.33.
4 R.C. 3727.32 and 3727.34.
5 R.C. 3727.42, 3727.44, and 3727.45.
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The bill’s requirements are not entirely consistent with more recent changes to the hospital price
transparency rule, which took effect January 1, 2024, and July 1, 2024.6
Definitions
The bill relies on the following definitions.7
▪ “Standard charge” means the regular rate established by the hospital for a hospital item
or service provided to a specific group of paying patients and includes the gross charge,
the payor-specific negotiated charge, the de-identified minimum negotiated charge, the
de-identified maximum negotiated charge, and the discounted cash price.
▪ “Hospital items or services” mean all items or services that may be provided to a patient
in connection with an inpatient admission or outpatient department visit for which the
hospital has established a standard charge, including supplies and procedures, room and
board, hospital fees, and professional charges.
▪ “Federal price transparency law” means section 2718(e) of the “Public Health Service
Act,” 42 U.S.C. 300gg-18, and hospital price transparency rules adopted by the United
States Department of Health and Human Services and CMS implementing that section,
including the rules and requirements under 45 C.F.R. 180.
▪ “Shoppable service” means a service that a health care consumer may schedule in
advance.
▪ “Chargemaster” means the list maintained by the hospital of each hospital item or service
for which the hospital has established a charge.
▪ “Ancillary service” means a hospital item or service that a hospital customarily provides
as part of a shoppable service.
▪ “De-identified maximum negotiated charge” means the highest charge that a hospital
has negotiated with all third-party payors for a hospital item or service.
▪ “De-identified minimum negotiated charge” means the lowest charge that a hospital has
negotiated with all third-party payors for a hospital item or service.
▪ “Discounted cash price” means the charge that applies to an individual who pays cash, or
a cash equivalent, for a hospital item or service.
▪ “Gross charge” means the charge for a hospital item or service that is reflected on a
hospital’s chargemaster, absent any discounts.
▪ “Machine-readable format” means a digital representation of information in a file that
can be imported or read into a computer system for further processing and includes .XML,
.JSON, and .CSV formats.
6 45 Code of Federal Regulations (C.F.R.) Part 180.
7 R.C. 3727.31.
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▪ “Payor-specific negotiated charge” means the charge that a hospital has negotiated with
a third-party payor for a hospital item or service.
▪ “Service package” means an aggregation of individual hospital items or services into a
single service with a single charge.
▪ “Third-party payor” means an entity that is, by statute, contract, or agreement, legally
responsible for payment of a claim for a hospital item or service.
▪ “Personal data” means any information that is linked or reasonably linkable to an
identified or identifiable person in Ohio. It does not include publicly available information
or personal data that has been de-identified or aggregated so that neither the associated
person nor a device linked to that person can be reasonably identified.
▪ “Process” or “processing” means any operation or set of operations that are performed
on personal data, whether or not by automated means, including the collection, use,
storage, disclosure, analysis, deletion, transfer, or modification of personal data.
▪ “Publicly available information” means information that is lawfully made available from
federal, state, or local government records or widely available media.
▪ “Targeted advertising” means displaying an advertisement that is selected based on
personal data obtained from the use of a hospital’s internet-based price estimator tool
by a person in Ohio. It does not include any of the following:
 Advertising in response to the user’s request for information or feedback;
 Advertisements based on activities within a hospital’s own websites or online
applications;
 Advertisements based on the context of a user’s current search query, visit to a
website, or online application;
 Processing personal data solely for measuring or reporting advertising performance,
reach, or frequency.8
Standard charges for hospital items and services
Under the bill, each hospital must maintain a list of all standard charges, expressed in
dollar amounts, for all hospital items or services. A hospital also must ensure that the list of
standard charges is made available at all times to the public, including by posting the list
electronically. 9
8 R.C. 3727.31.
9 R.C. 3727.33(A).
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Single digital file – machine readable format
The bill requires the information contained in the list to be published in a single digital file
that is in a machine-readable format.10
List items
Each hospital must include all of the following items in the list of standard charges:
▪ A description of each hospital item or service that the hospital provides;
▪ The following charges for each hospital item or service when provided in either an
inpatient setting or outpatient department setting: the gross charge, the de-identified
minimum negotiated charge, the de-identified maximum negotiated charge, the
discounted cash price, the payor-specific negotiated charge, and any billing or accounting
code used by the hospital for the item or service.
In the case of the payor-specific negotiated charge, the bill requires the charge to be listed
by the third-party payor’s name and health plan associated with the charge and be displayed in
a manner that clearly associates the charge with each third-party payor and plan.
With respect to billing and accounting codes, the list may include the current procedural
terminology (CPT) code, the healthcare common procedure coding system (HCPCS) code, the
diagnosis related group (DRG) code, the national drug code (NDC), or another common
identifier.11
Hospital location
The standard charges contained in a hospital’s list must reflect the standard charges
applicable to a specific location, regardless of whether the hospital operates in more than one
location or under the same license as another hospital.12
Standard charges for shoppable services
Under the bill, each hospital must maintain and make publicly available a list of certain
standard charges for the hospital’s shoppable services. These standard charges include the
following: the de-identified minimum negotiated price, the de-identified maximum negotiated
price, the discounted cash price, and the payor-specific negotiated charge.13
Hospital selection of shoppable services
A hospital may select the shoppable services to be included on its list, subject to certain
conditions. First, the list must include at least 300 shoppable services, unless the hospital
10 R.C. 3727.33(D).
11 R.C. 3727.33(C).
12 R.C. 3727.33(B).
13 R.C. 3727.34(A).
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provides fewer than 300 shoppable cases. In that case, the list must include the number of
shoppable services the hospital provides.
Second, the list must include the 70 services that CMS specifies as shoppable services. If
the hospital does not provide all 70 of those services, the list must include as many of those
services as the hospital provides.
Third, in selecting a shoppable service for inclusion on the list, the bill requires the hospital
to consider how frequently it provides the service and the billing rate for the service. The hospital
also must prioritize the selection of services that are among the services it most frequently
provides.14
List items
The bill requires each hospital’s list of shoppable services to contain the following
information:
▪ A plain-language description of each shoppable service the list includes;
▪ The following charges for each shoppable service included on the list and any ancillary
service: the payor-specific negotiated charge, the discounted cash price or gross charge,
the de-identified minimum negotiated charge, the de-identified maximum negotiated
price, and any billing or accounting code used by the hospital.
In the case of the payor-specific negotiated charge, the bill requires it to be listed by the
third-party payor’s name and health plan associated with the charge and be displayed in a
manner that clearly associates the charge with each third-party payor and plan.
With respect to billing and accounting codes, the list may include