[Congressional Bills 119th Congress]
[From the U.S. Government Publishing Office]
[H.R. 9393 Introduced in House (IH)]
<DOC>
119th CONGRESS
2d Session
H. R. 9393
To promote price transparency in the health care sector.
_______________________________________________________________________
IN THE HOUSE OF REPRESENTATIVES
June 23, 2026
Mr. Guthrie (for himself and Mr. Pallone) introduced the following
bill; which was referred to the Committee on Energy and Commerce, and
in addition to the Committees on Ways and Means, and Education and
Workforce, for a period to be subsequently determined by the Speaker,
in each case for consideration of such provisions as fall within the
jurisdiction of the committee concerned
_______________________________________________________________________
A BILL
To promote price transparency in the health care sector.
Be it enacted by the Senate and House of Representatives of the
United States of America in Congress assembled,
SECTION 1. SHORT TITLE.
This Act may be cited as the ``Lower Costs, More Transparency Act
of 2026''.
SEC. 2. HOSPITAL PRICE TRANSPARENCY.
(a) Medicare.--
(1) In general.--Part E of title XVIII of the Social
Security Act (42 U.S.C. 1395x et seq.) is amended by adding at
the end the following new section:
``SEC. 1899D. HOSPITAL PRICE TRANSPARENCY.
``(a) Transparency Requirement.--
``(1) In general.--Beginning January 1, 2028, each
specified hospital that receives payment under this title for
furnishing items and services shall comply with the price
transparency requirement described in paragraph (2).
``(2) Requirement described.--
``(A) In general.--For purposes of paragraph (1),
the price transparency requirement described in this
paragraph is, with respect to a specified hospital,
that such hospital, in accordance with a method and
format established by the Secretary under subparagraph
(C), compile and make public (without subscription and
free of charge) for each year--
``(i) all of the hospital's standard
charges (including the information described in
subparagraph (B)) for each item and service
furnished by such hospital;
``(ii) information in a consumer-friendly
format (as specified by the Secretary)--
``(I) on the hospital's prices
(including the information described in
subparagraph (B)) for as many of the
Centers for Medicare & Medicaid
Services-specified shoppable services
that are furnished by the hospital, and
as many additional hospital-selected
shoppable services (or all such
additional services, if such hospital
furnishes fewer than 300 shoppable
services) as may be necessary for a
combined total of at least 300
shoppable services; and
``(II) that includes, with respect
to each Centers for Medicare & Medicaid
Services-specified shoppable service
that is not furnished by the hospital,
an indication that such service is not
so furnished;
``(iii) each type 2 national provider
identifier associated with the hospital or a
unit of the hospital; and
``(iv) an attestation that all information
made public pursuant to this subparagraph is
complete and accurate.
``(B) Information described.--For purposes of
subparagraph (A), the information described in this
subparagraph is, with respect to standard charges and
prices, as applicable, made public by a specified
hospital, the following:
``(i) A plain language description (as
specified by the Secretary) of each item or
service, accompanied by, as applicable, the
Healthcare Common Procedure Coding System code,
the diagnosis-related group, the national drug
code, or other identifier used or approved by
the Centers for Medicare & Medicaid Services.
``(ii) The gross charge, as applicable,
expressed as a dollar amount, for each such
item or service, when provided in, as
applicable, the inpatient setting and
outpatient department setting.
``(iii) For each such item or service when
provided in, as applicable, the inpatient and
outpatient department settings--
``(I) the discounted cash price, as
applicable, expressed as a dollar
amount; or
``(II) in the case no discounted
cash price is available for such item
or service, the median cash price
charged by the hospital (not including
charity care) to self-pay individuals
for such item or service when provided
in such settings for the previous three
years, expressed as a dollar amount.
``(iv) With respect to prices made public
pursuant to subparagraph (A)(ii), a link to a
consumer-friendly document that clearly
explains the hospital's charity care policy
that includes, if applicable, any sliding scale
payment structure employed for determining
prices.
``(v) The payer-specific negotiated
charges, as applicable, clearly associated with
the name of the third party payer and plan and
expressed as a dollar amount, that apply to
each such item or service when provided in, as
applicable, the inpatient setting and
outpatient department setting.
``(vi) The de-identified maximum and
minimum negotiated charges, as applicable, for
each such item or service, not including any
such charge that is $0.
``(vii) Any other additional information
the Secretary may require (in consultation with
stakeholders) for the purpose of improving the
accuracy of, or enabling consumers to easily
understand and compare, standard charges and
prices for an item or service, except
information that is duplicative of any other
reporting requirement under this subsection.
``(C) Uniform method and format.--Not later than
January 1, 2028, the Secretary shall establish a
standard, uniform method and format for specified
hospitals to use in compiling and making public
standard charges pursuant to subparagraph (A)(i) and a
standard, uniform method and format for such hospitals
to use in compiling and making public prices pursuant
to subparagraph (A)(ii). Such methods and formats--
``(i) shall, in the case of such method and
format for making public standard charges
pursuant to subparagraph (A)(i), ensure that
such charges are made available in a machine-
readable format (or a successor technology
specified by the Secretary);
``(ii) may be similar to any template made
available by the Centers for Medicare &
Medicaid Services as of the date of the
enactment of this subparagraph;
``(iii) shall meet such standards as
determined appropriate by the Secretary in
order to ensure the accessibility and usability
of such charges and prices; and
``(iv) shall be updated as determined
appropriate by the Secretary, in consultation
with stakeholders.
``(3) Monitoring compliance.--The Secretary shall establish
processes to monitor and assess specified hospitals' compliance
with this subsection. Such processes shall include processes
relating to the following:
``(A) The evaluation and analysis of complaints
made by individuals or other entities relating to such
hospitals' compliance with this subsection.
``(B) The use of audits to ensure such hospitals'
compliance with this subsection.
``(C) The obtaining of additional information from
such hospitals to determine such hospitals' compliance
with this subsection (as determined appropriate by the
Secretary).
``(4) Enforcement.--
``(A) In general.--In the case of a specified
hospital that fails to comply with the requirements of
this subsection--
``(i) not later than 30 days after the date
on which the Secretary determines such failure
exists, the Secretary shall submit to such
hospital a notification of such determination
(which may include, as determined appropriate
by the Secretary, a request for a corrective
action plan (to be submitted not later than 45
days after such request is made) to comply with
such requirements); and
``(ii) in the case of a hospital that does
not receive a request for a corrective action
plan as part of a notification submitted by the
Secretary under clause (i)--
``(I) the Secretary shall, not
later than 60 days after such
notification is sent, determine whether
such hospital is in compliance with
such requirements; and
``(II) if the Secretary determines
under subclause (I) that such hospital
is not in compliance with such
requirements, the Secretary shall
either--
``(aa) submit to such
hospital a request for a
corrective action plan (to be
submitted not later than 45
days after such request is
made) to comply with such
requirements; or
``(bb) if the Secretary
determines that such hospital
has not taken meaningful
actions to come into compliance
since such notification was
sent, impose a civil monetary
penalty in accordance with
subparagraph (B).
``(B) Civil monetary penalty.--
``(i) In general.--Subject to clause (vii),
in addition to any other enforcement actions or
penalties that may apply under another
provision of Federal law, a specified hospital
that has received a request for a corrective
action plan under clause (i) or (ii) of
subparagraph (A) and fails to comply with the
requirements of this subsection by the date
that is 90 days after such request is made (or,
if such hospital has submitted such a
corrective action plan not later than 45 days
after the date such request was made, by the
date that is 90 days after the date of the
submission of such corrective action plan), and
a specified hospital with respect to which the
Secretary has made a determination described in
clause (ii)(II)(bb) of such subparagraph, shall
be subject to a civil monetary penalty of an
amount specified by the Secretary for each day
(beginning with the day on which the Secretary
first determined that such hospital was not
complying with such requirements) during which
such failure was ongoing. Such amount shall not
exceed--
``(I) in the case of a specified
hospital with 30 or fewer beds, $300
per day (or, in the case of such a
hospital that has been noncompliant
with such requirements for a 1-year
period or longer, beginning with the
first day following such 1-year period,
$400 per day);
``(II) in the case of a specified
hospital with more than 30 beds but
fewer than 101 beds, $12.50 per bed per
day (or, in the case of such a hospital
that has been noncompliant with such
requirements for a 1-year period or
longer, beginning with the first day
following such 1-year period, $15 per
bed per day);
``(III) in the case of a specified
hospital with more than 100 beds but
fewer than 201 beds, $17.50 per bed per
day (or, in the case of such a hospital
that has been noncompliant with such
requirements for a 1-year period or
longer, beginning with the first day
following such 1-year period, $20 per
bed per day);
``(IV) in the case of a specified
hospital with more than 200 beds but
fewer than 501 beds, $20 per bed per
day (or, in the case of such a hospital
that has been noncompliant with such
requirements for a 1-year period or
longer, beginning with the first day
following such 1-year period, $25 per
bed per day); and
``(V) in the case of a specified
hospital with more than 500 beds, $25
per bed per day (or, in the case of
such a hospital that has been
noncompliant with such requirements for
a 1-year period or longer, beginning
with the first day following such 1-
year period, $35 per bed per day).
``(ii) Increase authority.--In applying
this subparagraph with respect to violations
occurring in 2029 or a subsequent year, the
Secretary may through notice and comment
rulemaking increase--
``(I) the limitation on the per day
amount of any penalty applicable to a
specified hospital under clause (i)(I);
``(II) the limitations on the per
bed per day amount of any penalty
applicable under any of subclauses (II)
through (V) of clause (i); and
``(III) the amounts specified in
clause (iii)(II).
``(iii) Persistent noncompliance.--
``(I) In general.--In the case of a
specified hospital (other than a
specified hospital with 30 or fewer
beds) that the Secretary has determined
to be knowingly and willfully
noncompliant with the provisions of
this subsection for two or more 6-month
periods during any 3-year period, the
Secretary may increase any penalty
otherwise applicable under this
subparagraph by the amount specified in
subclause (II) with respect to such
hospital and may require such