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STATE OF WYOMING
HOUSE BILL NO. HB0121
Hospital pricing transparency.
Sponsored by: Representative(s) Singh, Andrew, Bear,
Haroldson, Harshman, Locke, Neiman and Rodriguez-Williams and Senator(s) Biteman,
Hutchings, Laursen, D, Rothfuss and Salazar
A BILL
for
1 AN ACT relating to public health and safety; requiring
2 hospitals to list prices for medical items and services as
3 specified; requiring the department of health to monitor
4 and enforce the provisions of this act; providing
5 penalties; prohibiting collection actions as specified;
6 requiring recommendations for proposed legislation;
7 providing definitions; requiring rulemaking; making
8 conforming amendments; and providing for effective dates.
9
10 Be It Enacted by the Legislature of the State of Wyoming:
11
12 Section 1. W.S. 35-2-1501 through 35-2-1511 are
13 created to read:
14
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1 ARTICLE 15
2 DISCLOSURE OF HOSPITAL PRICING
3
4 35-2-1501. Short title; purpose.
5
6 (a) This act shall be known and may be cited as the
7 "Hospital Price Transparency Act."
8
9 (b) The purpose of this act is to require hospitals
10 to disclose prices for certain items and services, to
11 provide civil penalties and to prohibit debt collection by
12 noncompliant facilities.
13
14 35-2-1502. Definitions.
15
16 (a) As used in this act:
17
18 (i) "Ancillary service" means a facility item or
19 service that a facility customarily provides as part of a
20 shoppable service;
21
22 (ii) "Department" means the department of
23 health;
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2 (iii) "De-identified maximum negotiated charge"
3 means the highest charge a facility has negotiated with all
4 third party payors for a facility item or service;
5
6 (iv) "De-identified minimum negotiated charge"
7 means the lowest charge a facility has negotiated with all
8 third party payors for a facility item or service;
9
10 (v) "Discounted cash price" means the charge
11 that applies to a person who pays cash, or a cash
12 equivalent, for a facility item or service;
13
14 (vi) "Facility" means a hospital licensed under
15 title 35 of the Wyoming statutes;
16
17 (vii) "Facility item or service" means all items
18 and services, including individual items and services and
19 service packages, that may be provided by a facility to a
20 patient in connection with an inpatient admission or an
21 outpatient department visit for which the facility has
22 established a standard charge, including:
23
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1 (A) Supplies and procedures;
2
3 (B) Room and board;
4
5 (C) Use of the facility and other areas,
6 generally referred to as facility fees;
7
8 (D) Services of health care providers
9 employed by the facility, generally referred to as
10 professional charges;
11
12 (E) Any other item or service for which a
13 facility has established a standard charge.
14
15 (viii) "Gross charge" means the charge for a
16 facility item or service that is reflected on a facility's
17 list, less any discounts;
18
19 (ix) "Machine-readable format" means a digital
20 representation of information that can be imported or read
21 into a computer system for processing;
22
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1 (x) "Payor-specific negotiated charge" means the
2 charge that a facility has negotiated with a third party
3 payor for a facility item or service;
4
5 (xi) "Shoppable service" means a service that
6 may be scheduled by a patient in advance;
7
8 (xii) "Standard charge" means the regular rate
9 established by the facility for a facility item or service
10 provided to a specific group of paying patients. The term
11 includes all of the following:
12
13 (A) The gross charge;
14
15 (B) The payor-specific negotiated charge;
16
17 (C) The de-identified minimum negotiated
18 charge;
19
20 (D) The de-identified maximum negotiated
21 charge;
22
23 (E) The discounted cash price.
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2 (xiii) "Third-party payor" means a person that
3 is, by statute, contract or agreement, legally responsible
4 for payment of a claim for a facility item or service;
5
6 (xiv) "This act" means W.S. 35-2-1501 through
7 35-2-1511.
8
9 35-2-1503. Public availability of price information;
10 requirements.
11
12 (a) Notwithstanding any other law, a facility shall
13 make public:
14
15 (i) A digital file in a machine-readable format
16 that contains a list of all standard charges, expressed in
17 dollar amounts, for all facility items or services as
18 described by W.S. 35-2-1504;
19
20 (ii) A consumer-friendly list of standard
21 charges for a limited set of shoppable services as provided
22 in W.S. 35-2-1505.
23
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1 35-2-1504. List of standard charges required.
2
3 (a) A facility shall:
4
5 (i) Maintain a list of all standard charges for
6 all facility items or services in accordance with this
7 section; and
8
9 (ii) Make the list required under paragraph (i)
10 of this subsection available at all times to the public,
11 including by posting the list in the manner provided by
12 this section.
13
14 (b) The standard charges contained in the list
15 required to be maintained by a facility under subsection
16 (a) of this section shall reflect the standard charges
17 applicable to that location of the facility, regardless of
18 whether the facility operates in more than one (1) location
19 or operates under the same license as another facility.
20
21 (c) The list required under subsection (a) of this
22 section shall include the following items, if applicable:
23
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1 (i) A description of each facility item or
2 service provided by the facility;
3
4 (ii) The following charges, expressed in dollar
5 amounts, for each individual facility item or service when
6 provided in either an inpatient setting or an outpatient
7 department setting:
8
9 (A) The gross charge;
10
11 (B) The de-identified minimum negotiated
12 charge;
13
14 (C) The de-identified maximum negotiated
15 charge;
16
17 (D) The discounted cash price;
18
19 (E) The payor-specific negotiated charge,
20 listed by the name of the third party payor and plan
21 associated with the charge and displayed in a manner that
22 clearly associates the charge with each third party payor
23 and plan; and
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2 (F) Any code used by the facility for
3 purposes of accounting or billing for the facility item or
4 service.
5
6 (d) The list required by subsection (a) of this
7 section shall be displayed in a prominent location on the
8 home page of the facility's publicly accessible website or
9 accessible through a link on that website. If the facility
10 operates multiple locations and maintains a single website,
11 the list shall be posted for each location the facility
12 operates in a manner that clearly associates the list with
13 the applicable location of the facility.
14
15 (e) The list required under subsection (a) of this
16 subsection shall:
17
18 (i) Be available:
19
20 (A) Free of charge;
21
22 (B) Without having to establish a user
23 account or password;
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2 (C) Without having to submit personal
3 identifying information;
4
5 (D) Without having to enter a code to
6 access the list.
7
8 (ii) Be accessible to a common commercial
9 operator of an internet search engine to the extent
10 necessary for the search engine to index and display the
11 list as a result in response to a search query of a user of
12 the search engine;
13
14 (iii) Be formatted in a manner prescribed by the
15 department;
16
17 (iv) Be digitally searchable;
18
19 (v) Use the naming convention specified by the
20 centers for Medicare and Medicaid services.
21
22 (f) In prescribing the format for the list under
23 paragraph (e)(iii) of this section, the department shall:
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2 (i) Develop a template that each facility shall
3 use in formatting the list;
4
5 (ii) Consider any applicable federal guidelines
6 for formatting similar lists required by federal law or
7 rule and ensure that the design of the template enables
8 health care researchers to compare the charges contained in
9 the lists maintained by each facility; and
10
11 (iii) Design the template to be substantially
12 similar to the template used by the centers for Medicare
13 and Medicaid services for purposes similar to those of this
14 act, if the department determines that designing the
15 template in that manner serves the purposes of paragraph
16 (ii) of this subsection and that the department benefits
17 from developing and requiring that substantially similar
18 design.
19
20 (g) Each facility shall update the list required by
21 subsection (a) of this section not less than annually. Each
22 facility shall clearly indicate the date on which the list
23 was updated.
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2 35-2-1505. Consumer-friendly list of shoppable
3 services; requirements.
4
5 (a) A facility shall maintain and make publicly
6 available a list of the standard charges described by W.S.
7 35-2-1504(c) for not less than three hundred (300)
8 shoppable services provided by the facility. Each facility
9 may select the shoppable services to be included in the
10 list, except that the list shall include:
11
12 (i) The seventy (70) services specified by the
13 centers for Medicare and Medicaid services in 45 C.F.R.
14 part 180; or
15
16 (ii) If the facility does not provide all of the
17 shoppable services described by paragraph (i) of this
18 subsection, as many of those shoppable services as the
19 facility does provide. Services that are not provided but
20 are Medicare and Medicaid listed services shall be
21 identified by the facility; and
22
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1 (iii) State each location where a facility
2 provides the shoppable service and whether the standard
3 charges included in the list apply at that location to the
4 provision of that shoppable service in an inpatient
5 setting, an outpatient department setting or in both of
6 those settings.
7
8 (b) In selecting a shoppable service for purposes of
9 inclusion in the list required by subsection (a) of this
10 section, a facility shall:
11
12 (i) Consider how frequently the facility
13 provides the services and the facility's billing rate for
14 that service; and
15
16 (ii) Prioritize the selection of services that
17 are among the services most frequently provided by the
18 facility.
19
20 (c) The list required by subsection (a) of this
21 section shall be:
22
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1 (i) Displayed in a manner prescribed by W.S.
2 35-2-1504(d);
3
4 (ii) Available:
5
6 (A) Free of charge;
7
8 (B) Without having to register or establish
9 a user account or password;
10
11 (C) Without having to submit personal
12 identifying information; and
13
14 (D) Without having to enter a code to
15 access the list.
16
17 (iii) Searchable by service description, billing
18 code and third party payor;
19
20 (iv) Updated in the manner prescribed by W.S.
21 35-2-1504(g);
22
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1 (v) Accessible to a common commercial operation
2 of an internet search engine to the extent necessary for
3 the search engine to index and display the list as a result
4 in response to a search query of a user of the search
5 engine; and
6
7 (vi) Formatted in a manner that is consistent
8 with the format prescribed by the department under W.S.
9 35-2-1504(e)(iii).
10
11 35-2-1506. Reporting requirement.
12
13 Each time a facility updates a list as required by W.S.
14 35-2-1504(g) and 35-2-1505(c)(iv), the facility shall
15 submit the updated list to the department. The department
16 shall prescribe the form in which the updated list shall be
17 submitted to the department.
18
19 35-2-1507. Monitoring.
20
21 (a) The department shall monitor each facility's
22 compliance with the requirements of this act using any of
23 the following methods:
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2 (i) Evaluating complaints made by persons to the
3 department regarding noncompliance with the act;
4
5 (ii) Reviewing any analysis prepared regarding
6 noncompliance with this act;
7
8 (iii) Auditing the websites of facilities for
9 compliance with this act;
10
11 (iv) Confirming that each facility submitted the
12 lists as required by W.S. 35-2-1506.
13
14 (b) Notwithstanding any provision of law to the
15 contrary, in considering an application for renewal of a
16 facility's license or certificate, the department shall
17 consider whether a facility is or has been in compliance
18 with this act.
19
20 35-2-1508. Material violation; corrective action
21 plan.
22
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1 (a) A facility materially violates this act if the
2 facility fails to:
3
4 (i) Comply with the requirements of W.S.
5 35-2-1503; or
6
7 (ii) Publicize the facility's standard charges
8 in the fo