II 

116TH CONGRESS 

1ST SESSION S. 1497 

To amend title XVIII of the Social Security Act to improve cost and quality 

transparency under the Medicare program, and for other purposes. 

IN THE SENATE OF THE UNITED STATES 

MAY 15, 2019 

Mr. WYDEN introduced the following bill; which was read twice and referred 

to the Committee on Finance 

A BILL 

To amend title XVIII of the Social Security Act to improve 

cost and quality transparency under the Medicare program, and for other purposes. 

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 Price 

5 Check Act of 2019’’. 

6 SEC. 2. IMPROVING COST AND QUALITY TRANSPARENCY 

7 UNDER THE MEDICARE PROGRAM. 

8 (a) SECRETARY.— 

9 (1) IN GENERAL.—Section 1804 of the Social 

10 Security Act (42 U.S.C. 1395b–2) is amended— 


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1 (A) in subsection (b), in the first sentence, 

2 by striking ‘‘The Secretary’’ and inserting 

3 ‘‘Subject to subsection (e)(1), the Secretary’’; 

4 and 

5 (B) by adding at the end the following new 

6 subsection: 

7 ‘‘(e) COST AND QUALITY TRANSPARENCY.— 

8 ‘‘(1) REQUIREMENTS FOR TOLL-FREE TELE9 PHONE NUMBER.—Not later than 1 year after the 

10 date of the enactment of this Act (except as pro11 vided in subparagraph (A)(iv)), the Secretary shall 

12 ensure that the following information is available to 

13 an individual who calls the toll-free telephone num14 ber under subsection (b): 

15 ‘‘(A) COSTS.—The following information 

16 regarding costs for items and services under 

17 parts A and B: 

18 ‘‘(i) The individual’s out-of-pocket 

19 costs for a specific item or service fur20 nished by a specific provider of services or 

21 supplier. 

22 ‘‘(ii) The payment amount under this 

23 title for such item or service furnished by 

24 such provider or supplier. 


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1 ‘‘(iii) The total allowable charges for 

2 such item or service furnished by such pro3 vider or supplier. 

4 ‘‘(iv) Not later than 2 years after the 

5 date of the enactment of this Act, the in6 formation described in clauses (i) through 

7 (iii) for items and services that are fre8 quently furnished together with the item or 

9 service described in such clauses, as deter10 mined by the Secretary. 

11 ‘‘(v) An explanation of the cost-shar12 ing components under parts A and B, in13 cluding with respect to— 

14 ‘‘(I) deductibles; 

15 ‘‘(II) copayments; and 

16 ‘‘(III) coinsurance. 

17 ‘‘(B) QUALITY.—Quality information avail18 able through the Medicare Physician Compare, 

19 Hospital Compare, Nursing Home Compare, 

20 Dialysis Facility Compare, Inpatient Rehabilita21 tion Facility Compare, Long-Term Care Hos22 pital Compare, and Hospice Compare websites. 

23 ‘‘(C) ADDITIONAL INFORMATION.—Other 

24 cost and quality information determined appro25 priate by the Secretary. 


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1 ‘‘(2) INTERNET WEBSITE.— 

2 ‘‘(A) IN GENERAL.—Not later than 2 years 

3 after the date of the enactment of this Act, the 

4 Secretary shall ensure that an internet website 

5 is in place that meets the following require6 ments: 

7 ‘‘(i) SEARCH FUNCTION.—Subject to 

8 clause (iv), the internet website contains a 

9 search function that enables an individual 

10 to search for an item or service in a geo11 graphic area— 

12 ‘‘(I) by the type of item or serv13 ice; and 

14 ‘‘(II) by providers of services or 

15 suppliers, including both a general 

16 search and search by a specific name. 

17 ‘‘(ii) INFORMATION.—The internet 

18 website is able to provide the information 

19 described in paragraph (1). 

20 ‘‘(iii) COMPARE FUNCTION.—The 

21 internet website contains a compare func22 tion that enables an individual to compare 

23 the out-of-pocket costs and quality for an 

24 item or service furnished by different pro25 viders of services or suppliers. 


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1 ‘‘(B) LIMIT.—The Secretary may limit the 

2 number of items and services for which infor3 mation is available on the website but shall en4 sure that items and services which account for 

5 at least 50 percent of spending under parts A 

6 and B are included. 

7 ‘‘(C) EXISTING WEBSITE.—The Secretary 

8 may comply with the requirements under this 

9 paragraph through the use of an internet 

10 website that is in place as of the date of the en11 actment of this subsection. 

12 ‘‘(3) ALERT REGARDING ESTIMATES OF

13 COSTS.—The Secretary shall ensure that individuals 

14 receiving cost information under paragraph (1) or 

15 (2) are alerted that the information provided is an 

16 estimate and that the actual costs that the indi17 vidual will be responsible for may vary.’’. 

18 (2) FUNDING.—There are appropriated to the 

19 Secretary of Health and Human Services such sums 

20 as the Secretary determines are necessary to carry 

21 out subsection (e) of section 1804 of the Social Se22 curity Act, as added by paragraph (1). 

23 (b) MEDICARE ADVANTAGE.—Section 1852 of the 

24 Social Security Act (42 U.S.C. 1395w–22) is amended— 


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1 (1) in subsection (c), by adding at the end the 

2 following new paragraph: 

3 ‘‘(3) COST AND QUALITY TRANSPARENCY.—For 

4 plan year 2021 and subsequent plan years, subject 

5 to paragraph (4) of subsection (o), the Medicare Ad6 vantage organization shall comply with the require7 ments under such subsection).’’; and 

8 (2) by adding at the end the following new sub9 section: 

10 ‘‘(o) COST AND QUALITY TRANSPARENCY.— 

11 ‘‘(1) TOLL-FREE TELEPHONE NUMBER.— 

12 ‘‘(A) IN GENERAL.—Each Medicare Ad13 vantage organization offering a Medicare Ad14 vantage plan shall have in place a toll-free tele15 phone number under which enrollees in the plan 

16 that call the telephone number are able to re17 ceive the following information: 

18 ‘‘(i) COSTS FOR ITEMS AND SERV19 ICES.—The following information regard20 ing costs for items and services under the 

21 plan: 

22 ‘‘(I) The enrollee’s out-of-pocket 

23 costs for a specific item or service fur24 nished by a specific in-network pro25 vider of services or supplier. 


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1 ‘‘(II) The information described 

2 in subclause (I) for items and services 

3 that are frequently furnished together 

4 with the item or service described in 

5 such subclause, as determined by the 

6 Secretary. 

7 ‘‘(III) An explanation of the cost8 sharing components, both generally 

9 and under the plan specifically, in10 cluding with respect to— 

11 ‘‘(aa) deductibles; 

12 ‘‘(bb) copayments; and 

13 ‘‘(cc) coinsurance. 

14 ‘‘(ii) COSTS FOR COVERED PART D

15 DRUGS.—In the case of an MA–PD plan, 

16 the information described in section 

17 1860D–4(o)(1)(A). 

18 ‘‘(iii) QUALITY.—Information on the 

19 quality of items and services furnished by 

20 providers of services and suppliers under 

21 the plan, as determined appropriate by the 

22 Secretary. 

23 ‘‘(iv) OUT-OF-NETWORK PRO24 VIDERS.—If an enrollee of the plan reVerDate Sep 11 2014 16:54 May 25, 2019 Jkt 089200 PO 00000 Frm 00007 Fmt 6652 Sfmt 6201 E:\BILLS\S1497.IS S1497

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1 quests information on an out-of-network 

2 provider of services or supplier,— 

3 ‘‘(I) information on the out-of4 network benefits offered under the 

5 plan; and 

6 ‘‘(II) other information, as deter7 mined appropriate by the Secretary. 

8 ‘‘(v) ADDITIONAL INFORMATION.— 

9 Other cost and quality information deter10 mined appropriate by the Secretary. 

11 ‘‘(B) ACCESS.—The toll-free telephone 

12 number under subparagraph (A) shall be acces13 sible by calling a number directly or by charge14 free transfer pursuant to section 1804(b). 

15 ‘‘(C) INTEGRATION WITH EXISTING TELE16 PHONE NUMBER.—The requirements for a toll17 free telephone number under subparagraph (A) 

18 may be provided through an existing enrollee 

19 toll-free telephone number. 

20 ‘‘(2) INTERNET WEBSITE.— 

21 ‘‘(A) IN GENERAL.—Subject to clause (iv), 

22 each Medicare Advantage organization offering 

23 a Medicare Advantage plan shall have in place 

24 an internet website that meets the following re25 quirements: 


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1 ‘‘(i) SEARCH FUNCTION.—The inter2 net website contains a search function that 

3 enables an enrollee to search— 

4 ‘‘(I) for an item or service in a 

5 geographic area— 

6 ‘‘(aa) by the type of item or 

7 service; and 

8 ‘‘(bb) by providers of serv9 ices or suppliers; and 

10 ‘‘(II) in the case of an MA–PD 

11 plan, for a covered part D drug under 

12 the plan. 

13 ‘‘(ii) INFORMATION.—The internet 

14 website is able to provide the information 

15 described in— 

16 ‘‘(I) paragraph (1)(A); and 

17 ‘‘(II) in the case of an MA–PD 

18 plan, section 1860D–4(o)(1)(A). 

19 ‘‘(iii) COMPARE FUNCTION.—The 

20 internet website contains a compare func21 tion that enables an enrollee to compare— 

22 ‘‘(I) the out-of-pocket costs and 

23 quality for an item or service fur24 nished by different providers of serv25 ices or suppliers; and 


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1 ‘‘(II) in the case of an MA–PD 

2 plan, each of subclauses (I) and (II) 

3 of section 1860D–4(o)(2)(A)(iii) for a 

4 covered part D drug. 

5 ‘‘(iv) LIMIT.—A Medicare Advantage 

6 organization may limit the number of 

7 items and services for which information is 

8 available on the website pursuant to the 

9 limits established by the Secretary under 

10 section 1804(e)(2)(A)(iv). 

11 ‘‘(B) INTEGRATION WITH EXISTING INTER12 NET WEBSITE.—If a Medicare Advantage orga13 nization offering a Medicare Advantage plan 

14 has in place an internet website for the plan as 

15 of the date of the enactment of this subsection, 

16 the organization shall integrate the require17 ments under subparagraph (A) into such 

18 website, including through the same log-in proc19 ess as the existing website. 

20 ‘‘(C) LINK TO AN EXTERNAL INTERNET

21 WEBSITE FOR INFORMATION ON COVERED PART

22 D DRUGS.—A Medicare Advantage organization 

23 offering a Medicare Advantage plan may pro24 vide the information described subparagraph 

25 (A)(ii)(II) for the plan through a link on the 


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1 plan’s internet website to an external internet 

2 website. 

3 ‘‘(3) ALERT REGARDING ESTIMATES OF

4 COSTS.—Each Medicare Advantage organization of5 fering a Medicare Advantage plan shall ensure that 

6 enrollees of the plan receiving cost information 

7 under paragraph (1) or (2) are alerted that the in8 formation provided is an estimate and that the ac9 tual costs that the enrollee will be responsible for 

10 may vary. 

11 ‘‘(4) EXEMPTION.—The requirements of this 

12 subsection shall not apply to a Medicare Advantage 

13 organization if the total number of enrollees in all 

14 the Medicare Advantage plans offered by the organi15 zation is less than a number of enrollees determined 

16 appropriate by the Secretary.’’. 

17 (c) PRESCRIPTION DRUG PLANS.—Section 1860D–4 

18 of the Social Security Act (42 U.S.C. 1395w–104) is 

19 amended— 

20 (1) by redesignating the subsection (m) as 

21 added by section 6063(c) of the SUPPORT for Pa22 tients and Communities Act (Public Law 115–271) 

23 as subsection (n); and 

24 (2) by adding at the end the following new sub25 section: 


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1 ‘‘(o) COST TRANSPARENCY.—For plan year 2021 and 

2 subsequent plan years, subject to paragraph (4), each 

3 PDP sponsor offering a prescription drug plan shall com4 ply with the following: 

5 ‘‘(1) TOLL-FREE TELEPHONE NUMBER.— 

6 ‘‘(A) IN GENERAL.—The PDP sponsor of7 fering the prescription drug plan shall have in 

8 place a toll-free telephone number under which 

9 enrollees in the plan that call the telephone 

10 number are able to receive the following infor11 mation: 

12 ‘‘(i) The enrollee’s out-of-pocket costs 

13 for a specific covered part D drug filled by 

14 a specific in-network pharmacy. 

15 ‘‘(ii) An explanation of the cost-shar16 ing components for covered part D drugs, 

17 both generally and under the plan specifi18 cally, including with respect to— 

19 ‘‘(I) deductibles; 

20 ‘‘(II) copayments; and 

21 ‘‘(III) coinsurance. 

22 ‘‘(B) INTEGRATION WITH EXISTING TELE23 PHONE NUMBER.—The requirements for a toll24 free telephone number under subparagraph (A) 


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1 may be provided through an existing enrollee 

2 toll-free telephone number. 

3 ‘‘(2) INTERNET WEBSITE.— 

4 ‘‘(A) IN GENERAL.—Each PDP sponsor 

5 offering a prescription drug plan shall have in 

6 place an internet website that meets the fol7 lowing requirements: 

8 ‘‘(i) SEARCH FUNCTION.—The inter9 net website contains a search function that 

10 enables an enrollee to search for a covered 

11 part D drug under the plan. 

12 ‘‘(ii) INFORMATION.—The internet 

13 website is able to provide the information 

14 described in subparagraph (A) of para15 graph (1). 

16 ‘‘(iii) COMPARE FUNCTION.—The 

17 internet website contains a compare func18 tion that enables an enrollee to compare 

19 each of the following for a covered part D 

20 drug: 

21 ‘‘(I) The out-of-pocket costs for 

22 multiple pharmacies, including mail 

23 order if available. 

24 ‘‘(II) The out-of-pocket costs for 

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1 tions, including but not limited to ge2 neric alternatives. 

3 ‘‘(B) INTEGRATION WITH EXISTING INTER4 NET WEBSITE.—If a PDP sponsor offering a 

5 prescription drug plan has in place an internet 

6 website for the plan as of the date of the enact7 ment of this subsection, the organization shall 

8 integrate the requirements under subparagraph 

9 (A) into such website, including through the 

10 same log-in process as the existing website. 

11 ‘‘(C) LINK TO AN EXTERNAL INTERNET

12 WEBSITE.—A PDP sponsor offering a prescrip13 tion drug plan may provide the information de14 scribed subparagraph (A)(ii) for the plan 

15 through a link on the plan’s internet website to 

16 an external internet website. 

17 ‘‘(3) ALERT REGARDING ESTIMATES OF

18 COSTS.—Each PDP sponsor offering a prescription 

19 drug plan shall ensure that enrollees of the plan re20 ceiving cost information under paragraph (1) or (2) 

21 are alerted that the information provided is an esti22 mate and that the actual costs that the enrollee will 

23 be responsible for may vary. 

24 ‘‘(4) EXEMPTION.—The requirements of this 

25 subsection shall not apply to a PDP sponsor if the 


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1 total number of enrollees in all the prescription drug 

2 plans offered by the sponsor is less than a number 

3 of enrollees determined appropriate by the Sec4 retary.’’. 

5 SEC. 3. IMPROVING COST AND QUALITY TRANSPARENCY 

6 UNDER PRIVATE HEALTH INSURANCE. 

7 (a) IN GENERAL.—Title XXVII of the Public Health 

8 Service Act is amended by inserting after section 2715A 

9 (42 U.S.C. 300gg–15a) the following: 

10 ‘‘SEC. 2715B. IMPROVING COST AND QUALITY TRANS11 PARENCY UNDER PRIVATE HEALTH INSUR12 ANCE. 

13 ‘‘(a) TOLL-FREE TELEPHONE NUMBER.— 

14 ‘‘(1) IN GENERAL.—A group health plan and a 

15 health insurance issuer offering group or individual 

16 health insurance coverage shall have in place a toll17 free telephone number under which enrollees in the 

18 plan or coverage calling the telephone number are 

19 able to receive, directly or through charge-free trans20 fer, information regarding the quality of in-network 

21 providers and facilities, as defined by the Secretary, 

22 and the following information regarding out-of-pock23 et costs for benefits under the plan or coverage: 

24 ‘‘(A) The enrollee’s out-of-pocket costs for 

25 a specific covered benefit provided by a specific 


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1 in-network provider or facility, and other cov2 ered benefits frequently associated with the spe3 cific covered benefit, as determined by the Sec4 retary. 

5 ‘‘(B) An explanation of the cost-sharing 

6 components under the applicable plan or cov7 erage, including with respect to— 

8 ‘‘(i) deductibles; 

9 ‘‘(ii) copayments; and 

10 ‘‘(iii) coinsurance. 

11 ‘‘(C) With respect to prescription drugs 

12 covered by the plan or coverage— 

13 ‘‘(i) out-of-pocket costs; 

14 ‘‘(ii) variation in the costs, coverage, 

15 and prices described in clause (i) by phar16 macy options, including the preferred phar17 macy, mail order pharmacy (if applicable), 

18 and other pharmacies in the designated ge19 ographic area; and 

20 ‘‘(iii) variation in such costs with re21 spect to generic or other therapeutically 

22 equivalent alternatives. 

23 ‘‘(D) With respect to services provided by 

24 an out-of-network provider, a summary of the 

25 out-of-network benefits offered under the plan 


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1 or coverage, and other information determined 

2 appropriate by the Secretary; and 

3 ‘‘(E) Other information determined appro4 priate by the Secretary. 

5 ‘‘(2) INTEGRATION WITH EXISTING SERV6 ICES.—The requirements for a toll-free telephone 

7 number under paragraph (1) may be provided 

8 through an existing enrollee toll-free telephone num9 ber. 

10 ‘‘(3) PRESCRIPTION DRUG INFORMATION.—A 

11 group health plan or health insurance issuer that 

12 has a contract with another entity offering prescrip13 tion drug management services with respect to the 

14 plan or applicable health insurance coverage may 

15 satisfy the requirement to provide the information 

16 required under paragraph (1)(C) by connecting en17 rollees to a toll-free telephone service of such entity 

18 where such entity makes such information available. 

19 ‘‘(b) INTERNET WEBSITE.— 

20 ‘‘(1) IN GENERAL.—A group health plan and a 

21 health insurance issuer offering group or individual 

22 health insurance coverage shall have in place an 

23 internet website that meets the following require24 ments with respect to providing enrollees with infor25 mation regarding the quality of in-network providers 


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1 and facilities, as defined by the Secretary, and infor2 mation on out-of-pocket costs for benefits under the 

3 plan or coverage: 

4 ‘‘(A) SEARCH FUNCTION.—The internet 

5 website contains a search function that enables 

6 an enrollee to search for a benefit in a geo7 graphic area, at minimum— 

8 ‘‘(i) by the type of benefit; and 

9 ‘‘(ii) by providers in the area. 

10 ‘‘(B) COSTS.—The internet website is able 

11 to provide the following information: 

12 ‘‘(i) The enrollee’s out-of-pocket costs 

13 for a specific benefit provided by a specific 

14 in-network provider, and other covered 

15 benefits frequently associated with the spe16 cific covered benefit, as determined by the 

17 Secretary. 

18 ‘‘(ii) An explanation of the cost-shar19 ing components, under the applicable plan 

20 or coverage specifically, including with re21 spect to— 

22 ‘‘(I) deductibles; 

23 ‘‘(II) copayments; and 

24 ‘‘(III) coinsurance. 


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1 ‘‘(iii) With respect to prescription 

2 drugs covered by the plan or coverage— 

3 ‘‘(I) out-of-pocket costs; 

4 ‘‘(II) variation in the costs de5 scribed in subclause (I) by pharmacy 

6 options, including the preferred phar7 macy, mail order pharmacy (if appli8 cable), and other pharmacies in the 

9 designated geographic area; and 

10 ‘‘(III) variation in such costs, 

11 coverage, and prices with respect to 

12 generic or other therapeutically equiv13 alent alternatives. 

14 ‘‘(iv) With respect to services provided 

15 by an out-of-network provider, a summary 

16 of the out-of-network benefits offered 

17 under the plan or coverage, and other in18 formation determined appropriate by the 

19 Secretary; and 

20 ‘‘(v) Other information determined 

21 appropriate by the Secretary. 

22 ‘‘(C) COMPARE FUNCTION.—The internet 

23 website contains a compare function that en24 ables an enrollee to compare the out-of-pocket 


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1 costs and quality measures for a benefit fur2 nished by different providers. 

3 ‘‘(2) INTEGRATION.—If a group health plan or 

4 health insurance issuer has in place an internet 

5 website for enrollees in a plan or coverage as of the 

6 date of the enactment of this section, the plan or 

7 issuer shall integrate the requirements under para8 graph (1) into such website, including through the 

9 same log-in process as the existing website. 

10 ‘‘(3) EXTENT OF INFORMATION.—A group 

11 health plan or health insurance issuer may limit the 

12 number of health care services for which the infor13 mation required under paragraph (1)(B) is available 

14 on the website to a number determined by the Sec15 retary. 

16 ‘‘(4) PRESCRIPTION DRUG INFORMATION.—A 

17 group health plan or health insurance issuer that 

18 has a contract with another entity offering prescrip19 tion drug management services with respect to the 

20 plan or applicable health insurance coverage may 

21 satisfy the requirement to provide the information 

22 required under paragraph (1)(B)(iii) by providing a 

23 link to the internet website of such entity where 

24 such entity makes such information available. 


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1 ‘‘(c) DISCLOSURE REQUIREMENT.—A group health 

2 plan or health insurance issuer shall inform enrollees seek3 ing information through the toll-free telephone number 

4 under subsection (a) or the internet website under sub5 section (b) that the cost information provided are esti6 mates and that the actual amount the enrollee will be re7 sponsible for paying may vary. 

8 ‘‘(d) REGULATIONS.—The Secretary, in consultation 

9 with the Administrator of the Centers for Medicare & 

10 Medicaid Services, shall promulgate regulations to carry 

11 out this section in a manner similar to the requirements 

12 for out-of-pocket cost transparency applicable to Medicare 

13 Advantage organizations under section 1852(o) of the So14 cial Security Act. 

15 ‘‘(e) EXEMPTION.—The requirements of this section 

16 shall not apply to a small or regional group health plan, 

17 or to a small or regional health insurance issuer with re18 spect to health insurance coverage. The Secretary shall de19 fine ‘small or regional group health plan’ and ‘small or 

20 regional health insurance issuer’ for purposes of this sub21 section.’’. 

22 (b) EFFECTIVE DATE.—Section 2715A of the Public 

23 Health Service Act, as added by subsection (a), shall take 

24 effect on January 1, 2021. 

Æ 


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