As Introduced
135th General Assembly
Regular Session H. B. No. 704
2023-2024
Representatives Ferguson, Barhorst
A BILL
To amend section 3727.44; to amend, for the purpose 1
of adopting a new section number as indicated in 2
parentheses, section 3727.44 (3727.40); to enact 3
sections 3727.31, 3727.32, 3727.33, 3727.34, 4
3727.35, 3727.36, 3727.37, 3727.38, 3727.381, 5
and 3727.39; and to repeal sections 3727.42, 6
3727.43, and 3727.45 of the Revised Code 7
regarding the availability of hospital price 8
information. 9
BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF OHIO:
Section 1. That section 3727.44 be amended; section 10
3727.44 (3727.40) be amended for the purpose of adopting a new 11
section number as indicated in parentheses; and sections 12
3727.31, 3727.32, 3727.33, 3727.34, 3727.35, 3727.36, 3727.37, 13
3727.38, 3727.381, and 3727.39 of the Revised Code be enacted to 14
read as follows: 15
Sec. 3727.31. As used in sections 3727.31 to 3727.40 of 16
the Revised Code: 17
(A) "Ancillary service" means a hospital item or service 18
that a hospital customarily provides as part of a shoppable 19
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service. 20
(B) "Chargemaster" means the list maintained by a hospital 21
of each hospital item or service for which the hospital has 22
established a charge. 23
(C) "De-identified maximum negotiated charge" means the 24
highest charge that a hospital has negotiated with all third- 25
party payors for a hospital item or service. 26
(D) "De-identified minimum negotiated charge" means the 27
lowest charge that a hospital has negotiated with all third- 28
party payors for a hospital item or service. 29
(E) "Discounted cash price" means the charge that applies 30
to an individual who pays cash, or a cash equivalent, for a 31
hospital item or service. 32
(F) "Federal price transparency law" means section 2718(e) 33
of the "Public Health Service Act," 42 U.S.C. 300gg-18, and 34
hospital price transparency rules adopted by the United States 35
department of health and human services and the United States 36
centers for medicare and medicaid services implementing that 37
section, including the rules and requirements under 45 C.F.R. 38
180. 39
(G) "Hospital" has the same meaning as in section 3722.01 40
of the Revised Code, notwithstanding the meaning of that term in 41
3727.01 of the Revised Code. 42
(H) "Hospital items or services" means all items or 43
services, including individual items or services and service 44
packages, that may be provided by a hospital to a patient in 45
connection with an inpatient admission or an outpatient 46
department visit, as applicable, for which the hospital has 47
established a standard charge, including all of the following: 48
H. B. No. 704 Page 3
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(1) Supplies and procedures; 49
(2) Room and board; 50
(3) Use of the hospital and other areas, the charges for 51
which are generally referred to as facility fees; 52
(4) Services of physicians and non-physician 53
practitioners, employed by the hospital, the charges for which 54
are generally referred to as professional fees; 55
(5) Any other item or service for which a hospital has 56
established a standard charge. 57
(I) "Gross charge" means the charge for a hospital item or 58
service that is reflected on a hospital's chargemaster, absent 59
any discounts. 60
(J) "Machine-readable format" means a digital 61
representation of information in a file that can be imported or 62
read into a computer system for further processing. "Machine- 63
readable format" includes.XML,.JSON, and.CSV formats. 64
(K) "Payor-specific negotiated charge" means the charge 65
that a hospital has negotiated with a third-party payor for a 66
hospital item or service. 67
(L) "Personal data" means any information that is linked 68
or reasonably linkable to an identified or identifiable person 69
in this state. "Personal data" does not include either of the 70
following: 71
(1) Publicly available information; 72
(2) Personal data that has been de-identified or 73
aggregated using commercially reasonable methods such that 74
neither the associated person, nor a device linked to that 75
H. B. No. 704 Page 4
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person, can be reasonably identified. 76
(M) "Process" or "processing" means any operation or set 77
of operations that are performed on personal data, whether or 78
not by automated means, including the collection, use, storage, 79
disclosure, analysis, deletion, transfer, or modification of 80
personal data. 81
(N) "Publicly available information" means information 82
that is lawfully made available from federal, state, or local 83
government records or widely available media. 84
(O) "Service package" means an aggregation of individual 85
hospital items or services into a single service with a single 86
charge. 87
(P) "Shoppable service" means a service that may be 88
scheduled by a health care consumer in advance. 89
(Q) "Standard charge" means the regular rate established 90
by the hospital for a hospital item or service provided to a 91
specific group of paying patients. "Standard charge" includes 92
all of the following: 93
(1) The gross charge; 94
(2) The payor-specific negotiated charge; 95
(3) The de-identified minimum negotiated charge; 96
(4) The de-identified maximum negotiated charge; 97
(5) The discounted cash price. 98
(R) "Targeted advertising" means displaying an 99
advertisement that is selected based on personal data obtained 100
from the use of a hospital's internet-based price estimator tool 101
by a person in this state. "Targeted advertising" does not 102
H. B. No. 704 Page 5
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include any of the following: 103
(1) Advertising in response to the user's request for 104
information or feedback; 105
(2) Advertisements based on activities within a hospital's 106
own web sites or online applications; 107
(3) Advertisements based on the context of a user's 108
current search query, visit to a web site, or online 109
application; 110
(4) Processing personal data solely for measuring or 111
reporting advertising performance, reach, or frequency. 112
(S) "Third-party payor" means an entity that is, by 113
statute, contract, or agreement, legally responsible for payment 114
of a claim for a hospital item or service. 115
Sec. 3727.32. A hospital shall make public both of the 116
following: 117
(A) As described in section 3727.33 of the Revised Code, a 118
digital file in a machine-readable format that contains a list 119
of all standard charges, expressed in dollar amounts, for all 120
hospital items or services; 121
(B) As described in section 3727.34 of the Revised Code, a 122
consumer-friendly list of standard charges for the hospital's 123
shoppable services or an internet-based price estimator tool. 124
Sec. 3727.33. (A) A hospital shall maintain a list of all 125
standard charges for all hospital items or services in 126
accordance with this section. The hospital shall ensure that the 127
list is available at all times to the public, including by 128
posting the list electronically in the manner provided by this 129
section. 130
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(B) The standard charges contained in the list shall 131
reflect the standard charges applicable to that location of the 132
hospital, regardless of whether the hospital operates in more 133
than one location or operates under the same license as another 134
hospital. 135
(C) The list shall include the following information, as 136
applicable: 137
(1) A description of each hospital item or service 138
provided by the hospital; 139
(2) The following charges, expressed in dollar amounts, 140
for each particular hospital item or service when provided in 141
either an inpatient setting or an outpatient department setting, 142
as applicable: 143
(a) The gross charge; 144
(b) The de-identified minimum negotiated charge; 145
(c) The de-identified maximum negotiated charge; 146
(d) The discounted cash price; 147
(e) The payor-specific negotiated charge, listed by the 148
name of the third-party payor and health plan associated with 149
the charge and displayed in a manner that clearly associates the 150
charge with each third-party payor and health plan; 151
(f) Any code used by the hospital for purposes of 152
accounting or billing for the hospital item or service, 153
including the current procedural terminology (CPT) code, 154
healthcare common procedure coding system (HCPCS) code, 155
diagnosis related group (DRG) code, national drug code (NDC), or 156
other common identifier. 157
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(D) The information contained in the list shall be 158
published in a single digital file that is in a machine-readable 159
format. 160
(E) The list shall be displayed in a prominent location on 161
the home page of the hospital's publicly accessible internet web 162
site or be accessible by selecting a dedicated link that is 163
prominently displayed on that home page. If the hospital 164
operates multiple locations and maintains a single internet web 165
site, a separate list shall be posted for each location the 166
hospital operates and shall be displayed in a manner that 167
clearly associates the list with the applicable location. 168
(F) The list shall satisfy all of the following 169
conditions: 170
(1) Be available free of charge; without having to 171
register or establish a user account or password; without having 172
to submit personal identifying information, including any 173
information pertaining to an individual's health care coverage 174
or other benefits; and without having to overcome any other 175
impediment in order to access the list, including such 176
impediments as entering a code or completing any type of 177
security measure known as challenge-response authentication; 178
(2) Be accessible to a common commercial operator of an 179
internet search engine to the extent necessary for the search 180
engine to index the list and display the list as a result in 181
response to a search query of a user of the search engine; 182
(3) Be formatted in a manner prescribed by the template 183
developed under division (G) of this section; 184
(4) Be digitally searchable; 185
(5) Use the following naming convention specified by the 186
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United States centers for medicare and medicaid services, 187
specifically: 188
"__standardcharges.[jsonxmlcsv]." 189
(G) For purposes of division (F)(3) of this section, the 190
director of health shall develop a template that each hospital 191
shall use in formatting the list. In developing the template, 192
the director shall do both of the following: 193
(1) Consider any applicable federal guidelines for 194
formatting similar lists required by federal statutes or 195
regulations and ensure that the design of the template enables 196
health care consumers or other researchers to compare the 197
charges contained in the lists maintained by each hospital; 198
(2) Design the template to be substantially similar to the 199
template used by the United States centers for medicare and 200
medicaid services for purposes similar to those of sections 201
3727.31 to 3727.40 of the Revised Code, if the director 202
determines that designing the template in that manner serves the 203
purposes of this section and that the department of health 204
benefits from the director developing and requiring that 205
substantially similar design. 206
(H) At least once each year, the hospital shall update the 207
list it maintains under this section. The hospital shall clearly 208
indicate the date on which the list was most recently updated, 209
either on the list or in a manner that is clearly associated 210
with the list. 211
Sec. 3727.34. (A) Subject to division (E) of this section, 212
a hospital shall maintain and make publicly available a list of 213
the standard charges described in divisions (C)(2)(b), (c), (d), 214
and (e) of section 3727.33 of the Revised Code for the 215
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hospital's shoppable services. With respect to the shoppable 216
services that are included on the list, a hospital may select 217
the shoppable services to be included on the list, subject to 218
all of the following: 219
(1) The list shall include at least three hundred 220
shoppable services, unless the hospital provides fewer than 221
three hundred shoppable services, in which case the list shall 222
include the number of shoppable services that the hospital 223
provides. 224
(2) Of the shoppabale services selected for purposes of 225
division (A)(1) of this section, the list shall include the 226
seventy services specified as shoppable services by the United 227
States centers for medicare and medicaid services, unless the 228
hospital does not provide all of the seventy services, in which 229
case the list shall include as many of those services as the 230
hospital does provide. 231
(3) In selecting a shoppable service for purposes of 232
inclusion on the list, a hospital shall do both of the 233
following: 234
(a) Consider how frequently the hospital provides the 235
service and the hospital's billing rate for that service; 236
(b) Prioritize the selection of services that are among 237
the services