I 

109TH CONGRESS 

1ST SESSION H. R. 1362 

To amend title XVIII of the Social Security Act to provide for the public 

disclosure of prices for hospital and ambulatory surgical center procedures and drugs. 

IN THE HOUSE OF REPRESENTATIVES 

MARCH 17, 2005 

Mr. LIPINSKI (for himself and Mr. INGLIS of South Carolina) introduced the 

following bill; which was referred to the Committee on Ways and Means, 

and in addition to the Committee on Energy and Commerce, 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 amend title XVIII of the Social Security Act to provide 

for the public disclosure of prices for hospital and ambulatory surgical center procedures and drugs. 

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 ‘‘Hospital Price Disclo5 sure Act of 2005’’. 
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1 SEC. 2. PUBLIC DISCLOSURE OF HOSPITAL AND AMBULA2 TORY SURGICAL CENTER DATA. 

3 (a) REQUIREMENT.— 

4 (1) HOSPITALS.—Subsection (a)(1) of section 

5 1866 of the Social Security Act (42 U.S.C. 1395cc) 

6 is amended— 

7 (A) in subparagraph (U), by striking 

8 ‘‘and’’ at the end; 

9 (B) in subparagraph (V), by striking the 

10 period at the end and inserting ‘‘, and’’; and 

11 (C) by inserting after subparagraph (V) 

12 the following new subparagraph: 

13 ‘‘(W) in the case of a hospital, to report to the 

14 Secretary data in accordance with subsection (k)(1) 

15 and to post notice regarding such data in accordance 

16 with subsection (k)(2)(B).’’. 

17 (2) AMBULATORY SURGICAL CENTERS.—Section 

18 1832(a)(2)(F)(i) of such Act (42 U.S.C. 

19 1395k(a)(2)(F)(i)) is amended by inserting after 

20 ‘‘other standards’’ the following: ‘‘, including the re21 porting to the Secretary of data in accordance with 

22 section 1866(k)(1) and the posting of notice regard23 ing such data in accordance with section 

24 1866(k)(2)(B)’’. 

25 (b) DATA REPORTING BY HOSPITALS AND AMBULA26 TORY SURGICAL CENTERS FOR CERTAIN INPATIENT AND
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1 OUTPATIENT PROCEDURES AND INPATIENT DRUGS.— 

2 Section 1866 of such Act (42 U.S.C. 1395cc) is further 

3 amended by adding at the end the following new sub4 section: 

5 ‘‘(k) DATA REPORTING BY HOSPITALS AND AMBULA6 TORY SURGICAL CENTERS AND PUBLIC POSTING.— 

7 ‘‘(1) QUARTERLY REPORTING REQUIREMENT.— 

8 Not later than 45 days after the end of each cal9 endar quarter (beginning more than one year after 

10 the date of the enactment of this subsection), a hos11 pital shall report to the Secretary, for each proce12 dure or drug selected under paragraph (3), and an 

13 ambulatory surgical center shall report to the Sec14 retary, for each procedure selected under paragraph 

15 (3)(A)(ii), the following data: 

16 ‘‘(A) The frequency with which the hos17 pital performed the procedure, or administered 

18 the drug in an inpatient setting, or the center 

19 performed the procedure during such quarter. 

20 ‘‘(B) If the procedure was performed or 

21 the drug was so administered during such quar22 ter, the average and the median of the price 

23 charged by the hospital or center for such pro24 cedure or drug during such quarter. 

25 ‘‘(2) PUBLIC AVAILABILITY OF DATA.— 
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1 ‘‘(A) PUBLIC POSTING OF DATA.—The 

2 Secretary shall promptly post, on the official 

3 public Internet site of the Department of 

4 Health and Human Services, the data reported 

5 under paragraph (1). Such data shall be set 

6 forth in a manner that promotes price compari7 son among hospitals and ambulatory surgical 

8 centers. 

9 ‘‘(B) NOTICE OF AVAILABILITY.—A hos10 pital and ambulatory surgical center shall 

11 prominently post at each admission site of the 

12 hospital or center a notice of the availability of 

13 the data reported under paragraph (1) on the 

14 official public Internet site under subparagraph 

15 (A). 

16 ‘‘(3) SELECTION OF PROCEDURES AND

17 DRUGS.— 

18 ‘‘(A) INITIAL SELECTION.—Based on na19 tional data, the Secretary shall select the fol20 lowing: 

21 ‘‘(i) The 25 most frequently per22 formed hospital inpatient procedures. 

23 ‘‘(ii) The 25 most frequently per24 formed hospital outpatient procedures. 
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1 ‘‘(iii) The 50 most frequently adminis2 tered drugs in a hospital inpatient setting. 

3 ‘‘(B) UPDATING SELECTION.—The Sec4 retary shall periodically update the procedures 

5 and drugs selected under subparagraph (A). 

6 ‘‘(4) CIVIL MONEY PENALTY.—The Secretary 

7 may impose a civil money penalty of not more than 

8 $10,000 for each knowing violation of the provisions 

9 of paragraph (1) or (2)(B) by a hospital or ambula10 tory surgical center. A civil money penalty under 

11 this paragraph shall be imposed and collected in the 

12 same manner as a civil money penalty under sub13 section (a) of section 1128A is imposed and collected 

14 under that section. 

15 ‘‘(5) ADMINISTRATIVE PROVISIONS.— 

16 ‘‘(A) CLASSIFICATION OF PROCEDURES.— 

17 For purposes of this subsection, the Secretary 

18 shall establish rules for the classification of dif19 ferent procedures and for the assignment of 

20 items and services to those procedures. 

21 ‘‘(B) COMPUTATION OF AVERAGE AND ME22 DIAN PRICES.—For purposes of paragraph (1), 

23 the computation of an average and median 

24 price for a procedure or drug shall be in accord25 ance with a methodology prescribed by the Sec-
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1 retary. Such methodology may provide for re2 porting by the hospital or ambulatory surgical 

3 center of unit prices for specific items and serv4 ices included in a procedure, including appro5 priate per diem prices, and a method of con6 verting such unit prices for a procedure to an 

7 average and median price for such procedure. 

8 ‘‘(C) FORM OF REPORT AND NOTICE.—The 

9 Secretary shall specify the electronic form and 

10 manner by which a hospital or ambulatory sur11 gical center shall report data under paragraph 

12 (1) and the form for posting of notices under 

13 paragraph (2)(B). 

14 ‘‘(6) NON-PREEMPTION OF STATE LAWS.— 

15 Nothing in this subsection shall be construed as pre16 empting or otherwise affecting any provision of 

17 State law relating to the disclosure of price or other 

18 information for a hospital or ambulatory surgical 

19 center. 

20 ‘‘(7) DRUG DEFINED.—For purposes of this 

21 subsection, the term ‘drug’ includes a biological and 

22 a non-prescription drug, such as an ointment. ’’. 

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