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 H. B. No. 704 Page 2 As Introduced 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 As Introduced (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 As Introduced 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 As Introduced 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 H. B. No. 704 Page 6 As Introduced (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 H. B. No. 704 Page 7 As Introduced (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 H. B. No. 704 Page 8 As Introduced 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 H. B. No. 704 Page 9 As Introduced 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