The bill, dubbed the Health Care PRICE Transparency Act 2.0, will require all negotiated rates and cash prices between plans and providers to be accessible, according to a news release from Indiana Sen. Mike Braun. He is sponsoring the bill along with Vermont Sen. Bernie Sanders, Iowa Sen. Chuck Grassley and New Mexico Sen. Tina Smith.
The bill also requires actual prices for 300 shoppable services to be published, with prices for all services included by 2025, according to the release. The bill also would increase maximum annual penalties to $10 million.
Machine-readable files would be required for all negotiated rates between plans and providers, not just estimates. The bill would also expand price transparency requirements to clinical diagnostic labs, imaging centers and ASCs.
Other provisions include requiring price data standards including all billing codes for service, codifying the Transparency in Coverage rule, and requiring attestation by executives that all prices are accurate and complete. It would also prevent the preemption of state price transparency laws — except for ERISA group health plans — and provide group health plans the right to access, audit and review claims encounter data.
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