II 

116TH CONGRESS 

2D SESSION S. 4106 

To amend the Public Health Service Act to provide for hospital and insurer 

price transparency. 

IN THE SENATE OF THE UNITED STATES 

JUNE 30, 2020 

Mr. BRAUN (for himself, Mr. KENNEDY, Mrs. LOEFFLER, Mr. GRASSLEY, Mr. 

ENZI, Ms. ERNST, and Mr. BARRASSO) introduced the following bill; 

which was read twice and referred to the Committee on Health, Education, Labor, and Pensions 

A BILL 

To amend the Public Health Service Act to provide for 

hospital and insurer price transparency. 

1 Be it enacted by the Senate and House of Representa2 tives of the United States of America in Congress assembled, 

3 SECTION 1. SHORT TITLE. 

4 This Act may be cited as the ‘‘Health Care Prices 

5 Revealed and Information to Consumers Explained Trans6 parency Act’’ or the ‘‘Health Care PRICE Transparency 

7 Act’’. 


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1 SEC. 2. PRICE TRANSPARENCY REQUIREMENTS. 

2 (a) HOSPITALS.—Section 2718(e) of the Public 

3 Health Service Act (42 U.S.C. § 300gg–18(e)) is amend4 ed— 

5 (1) by striking ‘‘Each hospital’’ and inserting 

6 the following: 

7 ‘‘(1) IN GENERAL.—Each hospital’’; 

8 (2) by inserting ‘‘, in a machine-readable for9 mat, via open application program interfaces 

10 (APIs)’’ after ‘‘a list’’; 

11 (3) by inserting ‘‘, along with such additional 

12 information as the Secretary may require with re13 spect to such charges for purposes of promoting 

14 public awareness of hospital pricing in advance of 

15 receiving a hospital item or service’’ before the pe16 riod; and 

17 (4) by adding at the end the following: 

18 ‘‘(2) DEFINITION OF STANDARD CHARGES.— 

19 Notwithstanding any other provision of law, for pur20 poses of paragraph (1), the term ‘standard charges’ 

21 means the rates hospitals, including providers or en22 tities that contract with or practice at a hospital, 

23 charge for all items and services at a minimum, 

24 chargemaster rates, rates that hospitals negotiate 

25 with third party payers across all plans, including 

26 those related to a patient’s specific plan, discounted 


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1 cash prices, and other rates determined by the Sec2 retary. 

3 ‘‘(3) ENFORCEMENT.—In addition to any other 

4 enforcement actions or penalties that may apply 

5 under subsection (b)(3) or another provision of law, 

6 a hospital that fails to provide the information re7 quired by this subsection and has not completed a 

8 corrective action plan to comply with the require9 ments of such subsection shall be subject to a civil 

10 monetary penalty of an amount not to exceed $300 

11 per day that the violation is ongoing as determined 

12 by the Secretary. Such penalty shall be imposed and 

13 collected in the same manner as civil money pen14 alties under subsection (a) of section 1128A of the 

15 Social Security Act are imposed and collected.’’. 

16 (b) TRANSPARENCY IN COVERAGE.—Section 

17 1311(e)(3) of the Patient Protection and Affordable Care 

18 Act (42 U.S.C. 18031(e)(3)) is amended— 

19 (1) in subparagraph (A)— 

20 (A) in clause (vii), by inserting before the 

21 period the following: ‘‘, including, for all items 

22 and services covered under the plan, aggregate 

23 information on specific payments the plan has 

24 made to out-of-network health care providers on 

25 behalf of plan enrollees’’; and 


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1 (B) by designating clause (ix) as clause 

2 (x); and 

3 (C) by inserting after clause (viii), the fol4 lowing: 

5 ‘‘(ix) Information on the specific nego6 tiated payment rates between the plan and 

7 health care providers for all items and 

8 services covered under the plan.’’; 

9 (2) in subparagraph (B)— 

10 (A) in the heading, by striking ‘‘USE’’ and 

11 inserting ‘‘DELIVERY METHODS AND USE’’; 

12 (B) by inserting ‘‘, as applicable,’’ after 

13 ‘‘English proficiency’’; and 

14 (C) by inserting after the second sentence, 

15 the following: ‘‘The Secretary shall establish 

16 standards for electronic delivery and access to 

17 such information by individuals, free of charge, 

18 in machine readable format, through an inter19 net website and via open APIs.’’; 

20 (3) in subparagraph (C)— 

21 (A) in the first sentence, by inserting ‘‘or 

22 out-of-network provider’’ after ‘‘item or service 

23 by a participating provider’’; 

24 (B) in the second sentence, by striking 

25 ‘‘through an internet website’’ and inserting 


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1 ‘‘free of charge, in machine readable format, 

2 through an internet website, and via open APIs, 

3 in accordance with standards established by the 

4 Secretary,’’; and 

5 (C) by adding at the end the following: 

6 ‘‘Such information shall include specific nego7 tiated rates that allow for comparison between 

8 providers and across plans, and related to a pa9 tient’s specific plan, including after an enrollee 

10 has exceeded their deductible responsibility.’’; 

11 and 

12 (4) in subparagraph (D) by striking ‘‘subpara13 graph (A)’’ and inserting ‘‘subparagraphs (A), (B), 

14 and (C)’’. 

Æ 


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