I 
119TH CONGRESS 
1ST SESSION H. R. 5582 
To amend the Public Health Service Act to provide for hospital and insurer 
price transparency. 
IN THE HOUSE OF REPRESENTATIVES 
SEPTEMBER 26, 2025 
Mr. JAMES (for himself, Ms. GOODLANDER, Mrs. KIGGANS of Virginia, and 
Mr. DAVIS of North Carolina) introduced the following bill; which was re-
ferred to the Committee on Energy and Commerce, and in addition to 
the Committees on Education and Workforce, and Ways and Means, 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 com-
mittee concerned 
A BILL 
To amend the Public Health Service Act to provide for 
hospital and insurer price transparency. 
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled, 
SECTION 1. SHORT TITLE. 
This Act may be cited as the ‘‘Patients Deserve Price 
Tags Act’’. 
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SEC. 2. STRENGTHENING HOSPITAL PRICE TRANSPARENCY 
REQUIREMENTS. 
(a) IN GENERAL.—Section 2718(e) of the Public 
Health Service Act (42 U.S.C. 300gg–18(e)) is amended 
to read as follows: 
‘‘(e) STANDARD HOSPITAL CHARGES.— 
‘‘(1) IN GENERAL.— 
‘‘(A) 
DISCLOSURE
OF
STANDARD 
CHARGES.—Each hospital shall, in accordance 
with a method and format established by the 
Secretary under subparagraph (C), on a month-
ly basis compile and make public (without sub-
scription and free of charge)— 
‘‘(i) all of the hospital’s standard 
charges (including the information de-
scribed in subparagraph (B)) for each item 
and service furnished by such hospital; and 
‘‘(ii) hospital standard charge infor-
mation, including the information de-
scribed in subparagraph (B), in a con-
sumer-friendly format (as specified by the 
Secretary), that includes— 
‘‘(I) as many of the Centers for 
Medicare & Medicaid Services-speci-
fied shoppable services that are fur-
nished by the hospital, and as many 
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additional hospital-selected shoppable 
services (or all such additional serv-
ices, if such hospital furnishes fewer 
than 300 shoppable services) as may 
be necessary for a combined total of 
at 
least 
300 
shoppable 
services 
through December 31, 2026, after 
which the hospital’s prices shall in-
clude all shoppable services; and 
‘‘(II) with respect to each Cen-
ters for Medicare & Medicaid Serv-
ices-specified shoppable service that is 
not furnished by the hospital, an indi-
cation that such service is not so fur-
nished. 
‘‘(B) STANDARD CHARGES DESCRIBED.— 
For purposes of subparagraph (A), standard 
charges means: 
‘‘(i) A plain language description of 
each item or service, accompanied by any 
applicable billing codes, including modi-
fiers, using commonly recognized billing 
code sets, including the Current Proce-
dural Terminology code, the Healthcare 
Common Procedure Coding System code, 
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the diagnosis-related group, the National 
Drug Code, and other nationally recog-
nized identifier. 
‘‘(ii) The gross charge, expressed as a 
dollar amount, for each such item or serv-
ice, when provided in, as applicable, the in-
patient setting and outpatient department 
setting. 
‘‘(iii) The discounted cash price ex-
pressed as a dollar amount, for each such 
item or service when provided in, as appli-
cable, the inpatient setting and outpatient 
department setting (or, in the case no dis-
counted cash price is available for an item 
or service, the minimum cash price accept-
ed by the hospital from self-pay individuals 
for such item or service, expressed as a 
dollar amount, as well as, with respect to 
prices made public pursuant to subpara-
graph (A)(ii), a link to a consumer-friendly 
document that clearly explains the hos-
pital’s charity care policy). The hospital 
shall accept the discounted cash price as 
payment in full from any patient that 
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chooses to pay in cash without regard to 
the patient’s coverage. 
‘‘(iv) The payer-specific negotiated 
charges, expressed as a dollar amount and 
clearly associated with the name of the ap-
plicable third-party payer and name of 
each plan, that apply to each such item or 
service when provided in, as applicable, the 
inpatient setting and outpatient depart-
ment setting. If the charges are based on 
an 
algorithm, 
percentage 
of 
another 
amount, or other formula or criteria, the 
hospital also shall disclose such algorithm, 
percentage, formula, or criteria as set forth 
in its contract and any other terms, sched-
ules, exhibits, data, or other information 
referenced in any such contract as shall be 
required to determine and disclose the ne-
gotiated charge. 
‘‘(v) The de-identified maximum and 
minimum negotiated charges for each such 
item or service, expressed as a non-zero 
dollar amount. 
‘‘(vi) Any other additional information 
the Secretary may require for the purpose 
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of improving the accuracy of, or enabling 
consumers to easily understand and com-
pare, standard charges and prices for an 
item or service, except information that is 
duplicative of any other reporting require-
ment under this subsection. In the case of 
standard charges and prices for an item or 
service included as part of a bundled, per 
diem, episodic, or other similar arrange-
ment, the information described in this 
subparagraph shall be made available as 
determined appropriate by the Secretary. 
‘‘(C) UNIFORM METHOD AND FORMAT.— 
Not later than January 1, 2026, the Secretary 
shall establish a standard, uniform method and 
format for hospitals to use in compiling and 
making public standard charges pursuant to 
subparagraph (A)(i) and a standard, uniform 
method and format for such hospitals to use in 
compiling and making public prices pursuant to 
subparagraph (A)(ii). Such methods and for-
mats shall— 
‘‘(i) in the case of such method and 
format for making public standard charges 
pursuant to subparagraph (A)(i), ensure 
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that such charges are made available in a 
machine-readable spreadsheet format; 
‘‘(ii) meet such standards as deter-
mined appropriate by the Secretary in 
order to ensure the accessibility and 
usability of such charges and prices; and 
‘‘(iii) be updated as determined appro-
priate by the Secretary, in consultation 
with stakeholders. 
‘‘(2) NO
DEEMED
COMPLIANCE.—The avail-
ability of a price estimator tool shall not be consid-
ered to deem compliance with or otherwise vitiate 
the requirements of paragraph (1)(A)(ii) or any 
other requirements of this section. Furthermore, the 
use of an estimator tool shall not be used for pur-
poses of compliance with any provisions in this Sec-
tion. 
‘‘(3) MONITORING
COMPLIANCE.—The Sec-
retary shall, in consultation with the Inspector Gen-
eral of the Department of Health and Human Serv-
ices, establish a process to monitor compliance with 
this subsection. Such process shall ensure that each 
hospital’s compliance with this subsection is re-
viewed not less frequently than once every year. 
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‘‘(4) ATTESTATION.—A senior official from 
each hospital (the Chief Executive Officer, Chief Fi-
nancial Officer, or an official of equivalent seniority) 
shall attest to the accuracy and completeness of the 
disclosures made in accordance with the hospital 
price transparency requirements set forth in this 
regulation. Such attestation shall be deemed to be 
material to payment from the Federal Government 
to the hospital. 
‘‘(5) ENFORCEMENT.— 
‘‘(A) IN GENERAL.—In the case of a hos-
pital that fails to comply with the requirements 
of this subsection, not later than 30 days after 
the date on which the Secretary determines 
such failure exists, the Secretary shall submit 
to such hospital a notification of such deter-
mination, which shall include a request for a 
corrective action plan to comply with such re-
quirements. 
‘‘(B) CIVIL MONETARY PENALTY.— 
‘‘(i) IN GENERAL.—In addition to any 
other enforcement actions or penalties that 
may apply under another provision of law, 
a hospital that has received a request for 
a corrective action plan under subpara-
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graph (A) and fails to comply with the re-
quirements of this subsection by the date 
that is 45 days after such request is made 
shall be subject to a civil monetary penalty 
of an amount specified by the Secretary for 
each day (beginning with the day on which 
the Secretary first determined that such 
hospital was not complying with such re-
quirements) during which such failure was 
ongoing. Such amount shall not exceed— 
‘‘(I) in the case of a hospital with 
30 or fewer beds, $300 per day; 
‘‘(II) in the case of a hospital 
with more than 30 beds but fewer 
than 101 beds, $12.50 per bed per 
day (or, in the case of such a hospital 
that has been noncompliant with such 
requirements for a 1-year period or 
longer, beginning with the first day 
following such 1-year period, $15 per 
bed per day); 
‘‘(III) in the case of a hospital 
with more than 100 beds but fewer 
than 301 beds, $17.50 per bed per 
day (or, in the case of such a hospital 
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that has been noncompliant with such 
requirements for a 1-year period or 
longer, beginning with the first day 
following such 1-year period, $20 per 
bed per day); 
‘‘(IV) in the case of a hospital 
with more than 300 beds but fewer 
than 501 beds, $20 per bed per day 
(or, in the case of such a hospital that 
has been noncompliant with such re-
quirements for a 1-year period or 
longer, beginning with the first day 
following such 1-year period, $25 per 
bed per day); and 
‘‘(V) in the case of a hospital 
with more than 500 beds, $25 per bed 
per day (or, in the case of such a hos-
pital that has been noncompliant with 
such requirements for a 1-year period 
or longer, beginning with the first day 
following such 1-year period, $35 per 
bed per day). 
‘‘(ii) INCREASE
AUTHORITY.—In ap-
plying this subparagraph with respect to 
violations occurring in 2027 or a subse-
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quent year, the Secretary may through no-
tice and comment rulemaking increase— 
‘‘(I) the limitation on the per day 
amount of any penalty applicable to a 
hospital under clause (i)(I); 
‘‘(II) the limitations on the per 
bed per day amount of any penalty 
applicable under any of subclauses 
(II) through (V) of clause (i); and 
‘‘(III) the limitation on the in-
crease of any penalty applied under 
clause (iii) pursuant to the amounts 
specified in subclause (II) of such 
clause. 
‘‘(iii) 
PERSISTENT
NONCOMPLI-
ANCE.— 
‘‘(I) IN GENERAL.—In the case 
of a hospital that the Secretary has 
determined to be knowingly and will-
fully noncompliant with the provisions 
of this subsection two or more times 
during a 1-year period, the Secretary 
may increase any penalty otherwise 
applicable under this subparagraph by 
the amount specified in subclause (II) 
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with respect to such hospital and may 
require such hospital to complete such 
additional corrective actions plans as 
the Secretary may specify. 
‘‘(II) SPECIFIED
AMOUNT.—For 
purposes of subclause (I), the amount 
specified in this subclause is, with re-
spect to a hospital— 
‘‘(aa) with more than 30 
beds but fewer than 101 beds, an 
amount that is not less than 
$500,000 and not more than 
$1,000,000; 
‘‘(bb) with more than 100 
beds but fewer than 301 beds, an 
amount that is greater than 
$1,000,000 and not more than 
$2,000,000; 
‘‘(cc) with more than 300 
beds but fewer than 501 beds, an 
amount that is greater than 
$2,000,000 and not more than 
$4,000,000; and 
‘‘(dd) with more than 500 
beds, an amount that is not less 
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than $5,000,000 and not more 
than $10,000,000. 
‘‘(iv) PROVISION OF TECHNICAL AS-
SISTANCE.—The Secretary may, to the ex-
tent practicable, provide technical assist-
ance relating to compliance with the provi-
sions of this section to hospitals requesting 
such assistance. 
‘‘(v) APPLICATION OF CERTAIN PROVI-
SIONS.—The provisions of section 1128A 
(other than subsections (a) and (b) of such 
section) shall apply to a civil monetary 
penalty imposed under this subparagraph 
in the same manner as such provisions 
apply to a civil monetary penalty imposed 
under subsection (a) of such section. 
‘‘(C) NO WAIVER.—The Secretary shall not 
grant or extend any waiver, delay, tolling, or 
other mitigation of a civil monetary penalty for 
violation of this subsection. 
‘‘(6) DEFINITIONS.—For purposes of this sub-
section: 
‘‘(A) 
DISCOUNTED
CASH
PRICE.—The 
term ‘discounted cash price’ means the min-
imum charge, exclusive of any hospital or third- 
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party payer assistance, that the hospital accepts 
from an individual who pays cash, or cash 
equivalent, for a hospital-furnished item or 
service, without regard to patient coverage, as 
payment in full. 
‘‘(B) GROSS
CHARGE.—The term ‘gross 
charge’ means the charge for an individual item 
or service that is reflected on a hospital’s 
chargemaster, absent any discounts. 
‘‘(C) 
HOSPITAL.—The 
term 
‘hospital’ 
means a hospital (as defined in section 1861(e) 
of the Social Security Act), a critical access 
hospital (as defined in section 1861(mmm)(1) 
of the Social Security Act), or a rural emer-
gency hospital (as defined in section 1861(kkk) 
of the Social Security Act), together with any 
parent, subsidiary, or other affiliated provider 
or supplier of health care items and services 
without regard to whether such parent, sub-
sidiary, or other affiliated provider or supplier 
operates under separate licensure, certification, 
or designation. 
‘‘(D) 
PAYER-SPECIFIC
NEGOTIATED 
CHARGE.—The term ‘payer-specific negotiated 
charge’ means the charge that a hospital has 
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negotiated with a third-party payer for an item 
or service. 
‘‘(E) SHOPPABLE
SERVICE.—The term 
‘shoppable service’ means a service that can be 
scheduled by a health care consumer in advance 
and includes all ancillary items and services 
customarily furnished as part of such service. 
‘‘(F) THIRD-PARTY
PAYER.—The term 
‘third-party payer’ means an entity that is, by 
statute, contract, or agreement, legally respon-
sible for payment of a claim for a health care 
item or service. 
‘‘(7) RULEMAKING.—The Secretary shall imple-
ment this subsection through notice and comment 
rulemaking in accordance with section 553 of title 5, 
United States Code.’’. 
(b) EFFECTIVE DATE.— 
(1) IN
GENERAL.—The amendment made by 
subsection (a) shall apply beginning January 1, 
2026. 
(2) CONTINUED APPLICABILITY OF RULES FOR 
PREVIOUS YEARS.—Nothing in the amendment made 
by this section may be construed as affecting the ap-
plicability of the regulations codified at part 180 of 
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title 45, Code of Federal Regulations, before Janu-
ary 1, 2025. 
(c) CONTINUED APPLICABILITY OF STATE LAW.— 
The provisions of this Act shall not supersede any provi-
sion of State law that establishes, implements, or con-
tinues in effect any requirement or prohibition related to 
health care price transparency, except to the extent that 
such requirement or prohibition prevents the application 
of a requirement or prohibition of this Act. 
SEC. 3. INCREASING PRICE TRANSPARENCY OF CLINICAL 
DIAGNOSTIC LABORATORY TESTS. 
Section 2718 of the Public Health Service Act (42 
U.S.C. 300gg–18) is amended by adding at the end the 
following: 
‘‘(f) CLINICAL
DIAGNOSTIC
LABORATORY
PRICE 
TRANSPARENCY.— 
‘‘(1) IN GENERAL.—Beginning July 1, 2027, an 
applicable laboratory shall— 
‘‘(A) make publicly available on an internet 
website the information described in paragraph 
(2) with respect to each such specified clinical 
diagnostic laboratory test that such laboratory 
so furnishes; and 
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‘‘(B) ensure that such information is up-
dated not less frequently than monthly, if there 
have been any changes to such information. 
‘‘(2) INFORMATION DESCRIBED.—For purposes 
of paragraph (1), the information described in this 
paragraph is, with respect to an applicable labora-
tory and a specified clinical diagnostic laboratory 
test, the following: 
‘‘(A) A plain language description of each 
item or service, accompanied by any applicable 
billing codes, including modifiers, using com-
monly recognized billing code sets, including the 
Current Procedural Terminology code, the 
Healthcare Common Procedure Coding System 
code, the diagnosis-related group, the National 
Drug Code, and other nationally recognized 
identifier. 
‘‘(B) The gross charge expressed as a dol-
lar amount, for each such item or service. 
‘‘(C) The discounted cash price expressed 
as a dollar amount, for each such item or serv-
ice (or, in the case no discounted cash price is 
available for an item or service, the minimum 
cash price accepted by the laboratory from self- 
pay individuals for such item or service when 
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provided in such settings for the previous three 
years, expressed as a dollar amount, as well as, 
with respect to prices made public pursuant to 
subparagraph (A)(ii), a link to a consumer- 
friendly document that clearly explains the lab-
oratory’s charity care policy). The laboratory 
shall accept the discounted or minimum cash 
price as payment in full from any patient that 
chooses to pay in cash without regard to the pa-
tient’s coverage. 
‘‘(D) 
The 
payer-specific 
negotiated 
charges, expressed as a dollar amount and 
clearly associated with the name of the applica-
ble third-party payer and name of each plan, 
that apply to each such item or service when 
provided in, as applicable, the inpatient setting 
and outpatient department setting. If the 
charges are based on an algorithm, percentage 
of another amount, or other formula or criteria, 
the clinical diagnostic laboratory also shall dis-
close such algorithm, percentage, formula, or 
criteria as set forth in its contract and any 
other terms, schedules, exhibits, data, or other 
information referenced in any such contract as 
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shall be required to determine and disclose the 
negotiated charge. 
‘‘(E) The de-identified maximum and min-
imum negotiated charges for each such item or 
service, expressed as a non-zero dollar amount. 
‘‘(F) Any other additional information the 
Secretary may require for the purpose of im-
proving the accuracy of, or enabling consumers 
to easily understand and compare, standard 
charges and prices for an item or service, ex-
cept information that is duplicative of any other 
reporting requirement under this subsection. In 
the case of standard charges and prices for an 
item or service included as part of a bundled, 
per diem, episodic, or other similar arrange-
ment, the information described in this sub-
paragraph shall be made available as deter-
mined appropriate by the Secretary. 
‘‘(3) UNIFORM
METHOD
AND
FORMAT.—Not 
later than January 1, 2027, the Secretary shall es-
tablish a standard, uniform method and format for 
applicable laboratories to use in compiling and mak-
ing public information pursuant to paragraph (1). 
Such method and format shall— 
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‘‘(A) include a machine-readable spread-
sheet format containing the information de-
scribed in paragraph (2) for all items and serv-
ices furnished by each laboratory; 
‘‘(B) meet such standards as determined 
appropriate by the Secretary in order to ensure 
the accessibility and usability of such informa-
tion; and 
‘‘(C) be updated as determined appropriate 
by the Secretary, in consultation with stake-
holders. 
‘‘(4) INCLUSION
OF
ANCILLARY
SERVICES.— 
Any price or rate for a specified clinical diagnostic 
laboratory test available to be furnished by an appli-
cable laboratory made publicly available in accord-
ance with paragraph (1) shall include the price or 
rate for any ancillary item or service (including spec-
imen collection services, specimen transport, cen-
trifugation, aliquoting, labeling, requisition proc-
essing, and standard result reporting services) that 
would customarily and routinely be furnished by 
such laboratory as part of such test, as specified by 
the Secretary. 
‘‘(5) ENFORCEMENT.— 
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‘‘(A) IN GENERAL.—In the case that the 
Secretary determines that an applicable labora-
tory is not in compliance with paragraph (1)— 
‘‘(i) not later than 30 days after such 
determination, the Secretary shall notify 
such laboratory of such determination; and 
‘‘(ii) if such laboratory continues to 
fail to comply with such paragraph after 
the date that is 90 days after such notifi-
cation is sent, the Secretary may impose a 
civil monetary penalty in an amount not to 
exceed $300 for each day (beginning with 
the day on which the Secretary first deter-
mined that such laboratory was failing to 
comply with such paragraph) during which 
such failure is ongoing. 
‘‘(B) INCREASE AUTHORITY.—In applying 
this paragraph with respect to violations occur-
ring in 2028 or a subsequent year, the Sec-
retary may through notice and comment rule-
making increase the per day limitation on civil 
monetary penalties under subparagraph (A)(ii). 
‘‘(C) APPLICATION
OF
CERTAIN
PROVI-
SIONS.—The provisions of section 1128A of the 
Social Security Act (other than subsections (a) 
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and (b) of such section) shall apply to a civil 
monetary penalty imposed under this paragraph 
in the same manner as such provisions apply to 
a civil monetary penalty imposed under sub-
section (a) of such section. 
‘‘(6) PROVISION OF TECHNICAL ASSISTANCE.— 
The Secretary shall, to the extent practicable, pro-
vide technical assistance relating to compliance with 
the provisions of this subsection to applicable labora-
tories requesting such assistance. 
‘‘(7) DEFINITIONS.—In this subsection: 
‘‘(A) 
APPLICABLE
LABORATORY.—The 
term ‘applicable laboratory’ means a ‘labora-
tory’ as such term is defined in section 493.2, 
of title 42, Code of Federal Regulations (or a 
successor regulation), except that such term 
does not include a laboratory with respect to 
which standard charges and prices for specified 
clinical diagnostic laboratory tests furnished by 
such laboratory are made available by a hos-
pital pursuant to subsection (e) of this section. 
‘‘(B) DISCOUNTED
CASH
PRICE.—The 
term ‘discounted cash price’ means the charge 
that applies to an individual who pays cash, or 
cash equivalent, for an item or service. 
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‘‘(C) GROSS
CHARGE.—The term ‘gross 
charge’ means the charge for an individual item 
or service that is reflected on an applicable lab-
oratory’s chargemaster, absent any discounts. 
‘‘(D) 
PAYER-SPECIFIC
NEGOTIATED 
CHARGE.—The term ‘payer-specific negotiated 
charge’ means the charge that an applicable 
laboratory has negotiated with a third-party 
payer for an item or service. 
‘‘(E) SPECIFIED
CLINICAL
DIAGNOSTIC 
LABORATORY TEST.—The term ‘specified clin-
ical diagnostic laboratory test’ means a clinical 
diagnostic laboratory test that is included on 
the list of shoppable services specified by the 
Centers for Medicare & Medicaid Services (as 
described in subsection (e) of this section), 
other than such a test that is only available to 
be furnished by a single provider of services or 
supplier. 
‘‘(F) THIRD-PARTY
PAYER.—The term 
‘third-party payer’ means an entity that is, by 
statute, contract, or agreement, legally respon-
sible for payment of a claim for a health care 
item or service. 
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‘‘(8) RULEMAKING.—The Secretary shall imple-
ment this subsection through notice and comment 
rulemaking in accordance with section 553 of title 5, 
United States Code.’’. 
SEC. 4. IMAGING TRANSPARENCY. 
Section 2718 of the Public Health Service Act (42 
U.S.C. 300gg–18), as amended by section 3, is further 
amended by adding at the end the following: 
‘‘(g) IMAGING SERVICES PRICE TRANSPARENCY.— 
‘‘(1) IN GENERAL.—Beginning July 1, 2027, 
each provider of services or supplier that furnishes 
a specified imaging service, other than such a pro-
vider or supplier with respect to which standard 
charges and prices for such services furnished by 
such provider or supplier are made available by a 
hospital pursuant to subsection (e), shall— 
‘‘(A) make publicly available (in accord-
ance with paragraph (3)) on an internet website 
the information described in paragraph (2) with 
respect to each such service that such provider 
of services or supplier furnishes; and 
‘‘(B) ensure that such information is up-
dated not less frequently than annually. 
‘‘(2) INFORMATION DESCRIBED.—For purposes 
of paragraph (1), the information described in this 
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paragraph is, with respect to a provider of services 
or supplier and a specified imaging service, the fol-
lowing: 
‘‘(A) A plain language description of each 
item or service, accompanied by any applicable 
billing codes, including modifiers, using com-
monly recognized billing code sets, including the 
Current Procedural Terminology code, the 
Healthcare Common Procedure Coding System 
code, the diagnosis-related group, the National 
Drug Code, and other nationally recognized 
identifier. 
‘‘(B) The gross charge expressed as a dol-
lar amount, for each such item or service. 
‘‘(C) The discounted cash price expressed 
as a dollar amount, for each such item or serv-
ice (or, in the case no discounted cash price is 
available for an item or service, the minimum 
cash price accepted by the provider of services 
or supplier from self-pay individuals for such 
item or service when provided in such settings 
for the previous three years, expressed as a dol-
lar amount, as well as, with respect to prices 
made public pursuant to subparagraph (A)(ii), 
a link to a consumer-friendly document that 
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clearly explains the provider of services or sup-
plier’s charity care policy). The provider of 
services or supplier shall accept the discounted 
or minimum cash price as payment in full from 
any patient that chooses to pay in cash without 
regard to the patient’s coverage. 
‘‘(D) 
The 
payer-specific 
negotiated 
charges, expressed as a dollar amount and 
clearly associated with the name of the applica-
ble third-party payer and name of each plan, 
that apply to each such item or service when 
provided in, as applicable, the inpatient setting 
and outpatient department setting. If the 
charges are based on an algorithm, percentage 
of another amount, or other formula or criteria, 
the provider or supplier also shall disclose such 
algorithm, percentage, formula, or criteria as 
set forth in its contract and any other terms, 
schedules, exhibits, data, or other information 
referenced in any such contract as shall be re-
quired to determine and disclose the negotiated 
charge. 
‘‘(E) The de-identified maximum and min-
imum negotiated charges for each such item or 
service, expressed as a non-zero dollar amount. 
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‘‘(F) Any other additional information the 
Secretary may require for the purpose of im-
proving the accuracy of, or enabling consumers 
to easily understand and compare, standard 
charges and prices for an item or service, ex-
cept information that is duplicative of any other 
reporting requirement under this subsection. In 
the case of standard charges and prices for an 
item or service included as part of a bundled, 
per diem, episodic, or other similar arrange-
ment, the information described in this sub-
paragraph shall be made available as deter-
mined appropriate by the Secretary. 
‘‘(3) UNIFORM
METHOD
AND
FORMAT.—Not 
later than January 1, 2027, the Secretary shall es-
tablish a standard, uniform method and format for 
providers of services and suppliers to use in making 
public information described in paragraph (2). Any 
such method and format shall— 
‘‘(A) include a machine-readable spread-
sheet format containing the information de-
scribed in paragraph (2) for all items and serv-
ices furnished by each provider of services and 
supplier described in paragraph (1); 
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‘‘(B) meet such standards as determined 
appropriate by the Secretary in order to ensure 
the accessibility and usability of such informa-
tion; and 
‘‘(C) be updated as determined appropriate 
by the Secretary, in consultation with stake-
holders. 
‘‘(4) MONITORING
COMPLIANCE.—The Sec-
retary shall, through notice and comment rule-
making and in consultation with the Inspector Gen-
eral of the Department of Health and Human Serv-
ices, establish a process to monitor compliance with 
this subsection. 
‘‘(5) ENFORCEMENT.— 
‘‘(A) IN GENERAL.—In the case that the 
Secretary determines that a provider of services 
or supplier is not in compliance with paragraph 
(1)— 
‘‘(i) not later than 30 days after such 
determination, the Secretary shall notify 
such provider or supplier of such deter-
mination; 
‘‘(ii) upon request of the Secretary, 
such provider or supplier shall submit to 
the Secretary, not later than 45 days after 
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the date of such request, a corrective ac-
tion plan to comply with such paragraph; 
and 
‘‘(iii) if such provider or supplier con-
tinues to fail to comply with such para-
graph after the date that is 90 days after 
such notification is sent (or, in the case of 
such a provider or supplier that has sub-
mitted a corrective action plan described in 
clause (ii) in response to a request so de-
scribed, after the date that is 90 days after 
such submission), the Secretary may im-
pose a civil monetary penalty in an amount 
not to exceed $300 for each day (beginning 
with the day on which the Secretary first 
determined that such provider or supplier 
was failing to comply with such paragraph) 
during which such failure to comply or fail-
ure to submit is ongoing. 
‘‘(B) INCREASE AUTHORITY.—In applying 
this paragraph with respect to violations occur-
ring in 2027 or a subsequent year, the Sec-
retary may through notice and comment rule-
making increase the amount of the civil mone-
tary penalty under subparagraph (A)(iii). 
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‘‘(C) APPLICATION
OF
CERTAIN
PROVI-
SIONS.—The provisions of section 1128A of the 
Social Security Act (other than subsections (a) 
and (b) of such section) shall apply to a civil 
monetary penalty imposed under this paragraph 
in the same manner as such provisions apply to 
a civil monetary penalty imposed under sub-
section (a) of such section. 
‘‘(D) NO
AUTHORITY
TO
WAIVE
OR
RE-
DUCE PENALTY.—The Secretary shall not grant 
or extend any waiver, delay, tolling, or other 
mitigation of a civil monetary penalty for viola-
tion of this subsection. 
‘‘(E) PROVISION
OF
TECHNICAL
ASSIST-
ANCE.—The Secretary shall, to the extent prac-
ticable, provide technical assistance relating to 
compliance with the provisions of this sub-
section to providers of services and suppliers re-
questing such assistance. 
‘‘(F) CLARIFICATION
OF
NONAPPLICA-
BILITY
OF
OTHER
ENFORCEMENT
PROVI-
SIONS.—Notwithstanding any other provision of 
this title, this paragraph shall be the sole 
means of enforcing the provisions of this sub-
section. 
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‘‘(6) SPECIFIED IMAGING SERVICE DEFINED.— 
the term ‘specified imaging service’ means an imag-
ing service that is a Centers for Medicare & Med-
icaid Services-specified shoppable service (as de-
scribed in subsection (e)). 
‘‘(7) RULEMAKING.—The Secretary shall imple-
ment this subsection through notice and comment 
rulemaking in accordance with section 553 of title 5, 
United States Code.’’. 
SEC. 5. AMBULATORY SURGICAL CENTER PRICE TRANS-
PARENCY REQUIREMENTS. 
Section 2718 of the Public Health Service Act (42 
U.S.C. 300gg–18), as amended by section 4, is further 
amended by adding at the end the following: 
‘‘(h) AMBULATORY
SURGERY
CENTER
TRANS-
PARENCY.— 
‘‘(1) IN GENERAL.—Beginning July 1, 2027, 
each specified ambulatory surgical center shall com-
ply with the price transparency requirement de-
scribed in paragraph (2). 
‘‘(2) REQUIREMENT DESCRIBED.— 
‘‘(A) IN
GENERAL.—A specified ambula-
tory surgical center, in accordance with a meth-
od and format established by the Secretary 
under subparagraph (C), shall compile and 
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make public (without subscription and free of 
charge), for each year— 
‘‘(i) one or more lists, in a machine- 
readable format specified by the Secretary, 
of the ambulatory surgical center’s stand-
ard charges (including the information de-
scribed in subparagraph (B)) for each item 
and service furnished by such surgical cen-
ter; 
‘‘(ii) information in a consumer- 
friendly format (as specified by the Sec-
retary) on the ambulatory surgical center’s 
prices (including the information described 
in subparagraph (B)) for as many of the 
Centers for Medicare & Medicaid Services- 
specified shoppable services included on the 
list described in subsection (e) that are 
furnished by such surgical center, and as 
many additional ambulatory surgical cen-
ter-selected shoppable services (or all such 
additional services, if such surgical center 
furnishes fewer than 300 shoppable serv-
ices) as may be necessary for a combined 
total of at least 300 shoppable services; 
and 
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‘‘(iii) with respect to each Centers for 
Medicare & Medicaid Services-specified 
shoppable service (as described in clause 
(ii)) that is not furnished by the ambula-
tory surgical center, an indication that 
such service is not so furnished. 
‘‘(B) INFORMATION DESCRIBED.—For pur-
poses of subparagraph (A), the information de-
scribed in this subparagraph is, with respect to 
standard charges and prices made public by a 
specified ambulatory surgical center, the fol-
lowing: 
‘‘(i) A description of each item or 
service, accompanied by the Healthcare 
Common Procedure Coding System code, 
the national drug code, or other identifier 
used or approved by the Centers for Medi-
care & Medicaid Services. 
‘‘(ii) The gross charge, expressed as a 
dollar amount, for each such item or serv-
ice. 
‘‘(iii) The discounted cash price, ex-
pressed as a dollar amount, for each such 
item or service (or, in the case no dis-
counted cash price is available for an item 
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or service, the minimum cash price accept-
ed by the specified ambulatory surgical 
center from self-pay individuals for such 
item or service when provided in such set-
tings for the previous three years, ex-
pressed as a dollar amount, as well as, 
with respect to prices made public pursu-
ant to subparagraph (A)(ii), a link to a 
consumer-friendly document that clearly 
explains the provider of services or sup-
plier’s charity care policy). The specified 
ambulatory surgical center shall accept the 
discounted cash price as payment in full 
from any patient that chooses to pay in 
cash without regard to the patient’s cov-
erage. 
‘‘(iv) The payer-specific negotiated 
charges, expressed as a dollar amount and 
clearly associated with the name of the ap-
plicable third-party payer and name of 
each plan, that apply to each such item or 
service when provided in, as applicable, the 
inpatient setting and outpatient depart-
ment setting. If the charges are based on 
an 
algorithm, 
percentage 
of 
another 
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amount, or other formula or criteria, the 
ambulatory surgical center also shall dis-
close such algorithm, percentage, formula, 
or criteria as set forth in its contract and 
any other terms, schedules, exhibits, data, 
or other information referenced in any 
such contract as shall be required to deter-
mine and disclose the negotiated charge. 
‘‘(v) The de-identified maximum and 
minimum negotiated charges for each such 
item or service, expressed as a non-zero 
dollar amount. 
‘‘(vi) Any other additional information 
the Secretary may require for the purpose 
of improving the accuracy of, or enabling 
consumers to easily understand and com-
pare, standard charges and prices for an 
item or service, except information that is 
duplicative of any other reporting require-
ment under this subsection. 
‘‘(C) UNIFORM METHOD AND FORMAT.— 
Not later than January 1, 2027, the Secretary 
shall establish a standard, uniform method and 
format for specified ambulatory surgical centers 
to use in making public standard charges pur-
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suant to subparagraph (A)(i) and a standard, 
uniform method and format for such centers to 
use in making public prices pursuant to sub-
paragraph (A)(ii). Any such method and format 
shall— 
‘‘(i) in the case of such charges made 
public by an ambulatory surgical center, 
ensure that such charges are made avail-
able in a machine-readable format; 
‘‘(ii) meet such standards as deter-
mined appropriate by the Secretary in 
order to ensure the accessibility and 
usability of such charges and prices; and 
‘‘(iii) be updated as determined appro-
priate by the Secretary, in consultation 
with stakeholders. 
‘‘(3) NO
DEEMED
COMPLIANCE.—The avail-
ability of a price estimator tool shall not be consid-
ered to deem compliance with or otherwise vitiate 
the requirements of this subsection (aa). Further-
more, the use of an estimator tool shall not be used 
for purposes of compliance with any provisions in 
this subsection. 
‘‘(4) MONITORING
COMPLIANCE.—The Sec-
retary shall, in consultation with the Inspector Gen-
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eral of the Department of Health and Human Serv-
ices, establish a process to monitor compliance with 
this subsection. Such process shall ensure that each 
specified ambulatory surgical center’s compliance 
with this subsection is reviewed not less frequently 
than once every year. 
‘‘(5) ENFORCEMENT.— 
‘‘(A) IN GENERAL.—In the case of a speci-
fied ambulatory surgical center that fails to 
comply with the requirements of this sub-
section— 
‘‘(i) the Secretary shall notify such 
ambulatory surgical center of such failure 
not later than 30 days after the date on 
which the Secretary determines such fail-
ure exists; and 
‘‘(ii) upon request of the Secretary, 
the ambulatory surgical center shall submit 
to the Secretary, not later than 45 days 
after the date of such request, a corrective 
action plan to comply with such require-
ments. 
‘‘(B) CIVIL MONETARY PENALTY.— 
‘‘(i) IN GENERAL.—A specified ambu-
latory surgical center that has received a 
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notification under subparagraph (A)(i) and 
fails to comply with the requirements of 
this subsection by the date that is 90 days 
after such notification (or, in the case of 
an ambulatory surgical center that has 
submitted a corrective action plan de-
scribed in subparagraph (A)(ii) in response 
to a request so described, by the date that 
is 90 days after such submission) shall be 
subject to a civil monetary penalty of an 
amount specified by the Secretary for each 
day (beginning with the day on which the 
Secretary first determined that such hos-
pital was not complying with such require-
ments) during which such failure is ongo-
ing (not to exceed $300 per day). 
‘‘(ii) INCREASE
AUTHORITY.—In ap-
plying this subparagraph with respect to 
violations occurring in 2027 or a subse-
quent year, the Secretary may through no-
tice and comment rulemaking increase the 
limitation on the per day amount of any 
penalty applicable to a specified ambula-
tory surgical center under clause (i). 
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‘‘(iii) APPLICATION OF CERTAIN PRO-
VISIONS.—The provisions of section 1128A 
of the Social Security Act (other than sub-
sections (a) and (b) of such section) shall 
apply to a civil monetary penalty imposed 
under this subparagraph in the same man-
ner as such provisions apply to a civil mon-
etary penalty imposed under subsection (a) 
of such section. 
‘‘(iv) NO
AUTHORITY
TO
WAIVE
OR 
REDUCE
PENALTY.—The Secretary shall 
not grant or extend any waiver, delay, toll-
ing, or other mitigation of a civil monetary 
penalty for violation of this subsection. 
‘‘(6) PROVISION OF TECHNICAL ASSISTANCE.— 
The Secretary shall, to the extent practicable, pro-
vide technical assistance relating to compliance with 
the provisions of this subsection to specified ambula-
tory surgical centers requesting such assistance. 
‘‘(7) DEFINITIONS.—For purposes of this sec-
tion: 
‘‘(A) 
DISCOUNTED
CASH
PRICE.—The 
term ‘discounted cash price’ means the charge 
that applies to an individual who pays cash, or 
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cash equivalent, for a item or service furnished 
by an ambulatory surgical center. 
‘‘(B) GROSS
CHARGE.—The term ‘gross 
charge’ means the charge for an individual item 
or service that is reflected on a specified sur-
gical center’s chargemaster, absent any dis-
counts. 
‘‘(C) 
GROUP
HEALTH
PLAN; 
GROUP 
HEALTH
INSURANCE
COVERAGE; INDIVIDUAL 
HEALTH
INSURANCE
COVERAGE.—The terms 
‘group health plan’, ‘group health insurance 
coverage’, and ‘individual health insurance cov-
erage’ have the meaning given such terms in 
section 2791 of the Public Health Service Act. 
‘‘(D) 
PAYER-SPECIFIC
NEGOTIATED 
CHARGE.—The term ‘payer-specific negotiated 
charge’ means the charge that a specified sur-
gical center has negotiated with a third-party 
payer for an item or service. 
‘‘(E) SHOPPABLE
SERVICE.—The term 
‘shoppable service’ means a service that can be 
scheduled by a health care consumer in advance 
and includes all ancillary items and services 
customarily furnished as part of such service. 
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‘‘(F) SPECIFIED
AMBULATORY
SURGICAL 
CENTER.—The term ‘specified ambulatory sur-
gical center’ means an ambulatory surgical cen-
ter with respect to which a hospital (or any per-
son with an ownership or control interest (as 
defined in section 1124(a)(3) of the Social Se-
curity Act) in a hospital) is a person with an 
ownership or control interest (as so defined). 
‘‘(G) THIRD-PARTY
PAYER.—The term 
‘third-party payer’ means an entity that is, by 
statute, contract, or agreement, legally respon-
sible for payment of a claim for a health care 
item or service. 
‘‘(8) RULEMAKING.—The Secretary shall imple-
ment this subsection through notice and comment 
rulemaking in accordance with section 553 of title 5, 
United States Code.’’. 
SEC. 6. STRENGTHENING HEALTH COVERAGE TRANS-
PARENCY REQUIREMENTS. 
(a) 
TRANSPARENCY
IN
COVERAGE.—Section 
1311(e)(3)(C) of the Patient Protection and Affordable 
Care Act (42 U.S.C. 18031(e)(3)(C)) is amended— 
(1) by striking ‘‘The Exchange’’ and inserting 
the following: 
‘‘(i) IN GENERAL.—The Exchange’’; 
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(2) in clause (i), as inserted by paragraph (1)— 
(A) by striking ‘‘participating provider’’ 
and inserting ‘‘provider’’; 
(B) by inserting ‘‘shall include the infor-
mation specified in clause (ii) and’’ after ‘‘such 
information’’; 
(C) by striking ‘‘an Internet website’’ and 
inserting ‘‘a self-service tool that meets the re-
quirements of clause (iii)’’; and 
(D) by striking ‘‘and such other’’ and all 
that follows through the period and inserting 
‘‘or, at the option such individual, through a 
paper or phone disclosure (as selected by such 
individual and provided at no cost to such indi-
vidual) that meets such requirements as the 
Secretary may specify.’’; and 
(3) by adding at the end the following new 
clauses: 
‘‘(ii) SPECIFIED
INFORMATION.—For 
purposes of clause (i), the information 
specified in this clause is, with respect to 
benefits available under a health plan for 
an item or service furnished by a health 
care provider, the following: 
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‘‘(I) If such provider is a partici-
pating provider with respect to such 
item or service, the in-network rate 
(as defined in subparagraph (F)) for 
such item or service. 
‘‘(II) If such provider is not de-
scribed in subclause (I), the maximum 
allowed dollar amount for such item 
or service. 
‘‘(III) The amount of cost shar-
ing 
(including 
deductibles, 
copay-
ments, and coinsurance) that the indi-
vidual will incur for such item or serv-
ice (which, in the case such item or 
service is to be furnished by a pro-
vider described in subclause (II), shall 
be calculated using the maximum 
amount described in such subclause). 
‘‘(IV) The amount the individual 
has already accumulated with respect 
to any deductible or out of pocket 
maximum under the plan (broken 
down, in the case separate deductibles 
or maximums apply to separate indi-
viduals enrolled in the plan, by such 
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separate deductibles or maximums, in 
addition to any cumulative deductible 
or maximum). 
‘‘(V) In the case such plan im-
poses any frequency or volume limita-
tions with respect to such item or 
service (excluding medical necessity 
determinations), the amount that such 
individual has accrued towards such 
limitation with respect to such item or 
service. 
‘‘(VI) Any prior authorization, 
concurrent review, step therapy, fail 
first, or similar requirements applica-
ble to coverage of such item or service 
under such plan. 
‘‘(iii) SELF-SERVICE TOOL.—For pur-
poses of clause (i), a self-service tool estab-
lished by a health plan meets the require-
ments of this clause if such tool— 
‘‘(I) is based on an internet 
website; 
‘‘(II) provides for real-time re-
sponses to requests described in such 
clause; 
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‘‘(III) is updated in a manner 
such 
that 
information 
provided 
through such tool is timely and accu-
rate; 
‘‘(IV) allows such a request to be 
made with respect to an item or serv-
ice furnished by— 
‘‘(aa) a specific provider 
that is a participating provider 
with respect to such item or serv-
ice; 
‘‘(bb) all providers that are 
participating providers with re-
spect to such plan and such item 
or service; or 
‘‘(cc) a provider that is not 
described in item (bb); 
‘‘(V) provides that such a request 
may be made with respect to an item 
or service through use of— 
‘‘(aa) the billing code for 
such item or service; or 
‘‘(bb) through use of a de-
scriptive term for such item or 
service to produce a list of billing 
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code options from which the indi-
vidual selects to indicate the sub-
ject matter items or services; and 
‘‘(VI) holds a member harmless 
for the amount of any difference in 
excess of the amount of the individ-
ual’s responsibility generated by the 
self-service tool and the amount ulti-
mately billed or charged to the indi-
vidual.’’. 
(b) DISCLOSURE OF ADDITIONAL INFORMATION.— 
Section 1311(e)(3) of the Patient Protection and Afford-
able Care Act (42 U.S.C. 18031(e)(3)) is amended by add-
ing at the end the following new subparagraphs: 
‘‘(E) RATE
AND
PAYMENT
INFORMA-
TION.— 
‘‘(i) IN
GENERAL.—Not later than 
January 1, 2027, and every month there-
after, each health plan shall submit to the 
Exchange, the Secretary, the State insur-
ance commissioner, and make available to 
the public, the rate and payment informa-
tion described in clause (ii) in accordance 
with clause (iii). 
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‘‘(ii) RATE AND PAYMENT INFORMA-
TION DESCRIBED.—For purposes of clause 
(i), the rate and payment information de-
scribed in this clause is, with respect to a 
health plan, the following: 
‘‘(I) With respect to each item or 
service for which benefits are available 
under such plan (expressed as a dollar 
amount), including prescription drugs, 
identified by CPT, HCPCS, DRG, 
NDC, or other applicable nationally 
recognized identifier, including any 
applicable code modifiers, and accom-
panied by a brief description of the 
item or service, the in-network rate in 
effect as of the date of the submission 
of such information with each pro-
vider (identified by national provider 
identifier) that is a participating pro-
vider with respect to such item or 
service, other than such a rate in ef-
fect with a provider— 
‘‘(aa) that has submitted no 
claims; and 
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‘‘(bb) expects to receive no 
claims in the then applicable cal-
endar year for such item or serv-
ice to such plan. 
‘‘(II) With respect to each drug 
(identified by National Drug Code, J- 
code, or other commonly recognized 
billing code used for drugs) for which 
benefits are available under such plan: 
‘‘(aa) The in-network rate 
(expressed as a dollar amount), 
including the individual and total 
amounts for any bundled rates, 
in effect as of the first day of the 
month in which such information 
is made public with each provider 
that is a participating provider 
with respect to such drug. 
‘‘(bb) The historical net 
price paid by such plan (net of 
rebates, discounts, and price con-
cessions) (expressed as a dollar 
amount) for such drug dispensed 
or administered during the 90- 
day period beginning 180 days 
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before such date of submission to 
each provider that was a partici-
pating provider with respect to 
such drug, broken down by each 
such provider (identified by na-
tional provider identifier), other 
than such an amount paid to a 
provider that has submitted no 
claims for such drug to such 
plan. 
‘‘(III) With respect to each item 
or service for which benefits are avail-
able under such plan (expressed as a 
dollar amount), identified by CPT, 
DRG, HCPCS, NDC, or other appli-
cable nationally recognized identifier, 
including any applicable code modi-
fiers, and accompanied by a brief de-
scription of the item or service, the 
amount billed or charged by the pro-
vider, and the amount allowed by the 
plan, for each such item or service 
furnished during the 90-day period 
beginning 180 days before such date 
of submission by each provider that 
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was not a participating provider with 
respect to such item or service, broken 
down by each such provider (identified 
by national provider identifier), other 
than items and services with respect 
to which no claims for such item or 
service were submitted to such plan 
during such period. 
‘‘(iii) MANNER OF SUBMISSION.—Rate 
and payment information required to be 
submitted and made available under this 
subparagraph shall be so submitted and so 
made available as follows: 
‘‘(I) Information shall be con-
tained in 3 separate machine-readable 
files corresponding to the information 
described in each of subclauses (I) 
through (III) of clause (ii) that meet 
such requirements as specified by the 
Secretary through rulemaking, in con-
sultation with the Secretaries of 
Labor and the Treasury to apply com-
parable requirements to group health 
plans and to entities providing benefit 
management or other third-party ad-
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ministration services on a contractual 
basis with a group health plan. 
‘‘(II) Requirements specified by 
the Secretary through rulemaking 
shall ensure that: 
‘‘(aa) Such files are limited 
to an appropriate size, are made 
available in a widely available 
format that allows for informa-
tion contained in such files to be 
compared across health plans, 
and are accessible to individuals 
at no cost and without the need 
to establish a user account or 
provider other credentials. 
‘‘(bb) The rates, amounts, 
and prices to be disclosed include 
contractual terms containing cal-
culation formulae, pricing meth-
odologies, and other information 
necessary to determine the dollar 
value of reimbursement. 
‘‘(cc) Each such file includes 
each of the following data ele-
ments: 
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‘‘(AA) 
A 
numerical 
identifier 
for 
the 
group 
health plan and/or health in-
surance issuer (such as a 
Health Insurance Oversight 
System identifier). 
‘‘(BB) A plain-language 
description of the item or 
service (including, for drugs, 
the proprietary and non-
proprietary name assigned). 
‘‘(CC) The billing code, 
including 
any 
applicable 
modifiers, associated with 
such item or service, includ-
ing the Healthcare Common 
Procedure Coding System 
code, 
diagnosis-related 
group, national drug code, 
or other commonly recog-
nized code set. 
‘‘(DD) The place of 
service code. 
‘‘(EE) 
The 
National 
Provider Identifier or pro-
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vider 
Tax 
Identification 
Number. 
‘‘(III) The rate and payment in-
formation disclosed under subclauses 
(I) through (III) of clause (ii) shall be 
separately delineated for each item or 
service, regardless of whether such 
item or service is reimbursed as a part 
of a bundle, episode, or other group-
ing of items and services. 
‘‘(IV) An officer or executive of 
competent authority shall attest to the 
accuracy and completeness of infor-
mation submitted and made available 
under this subparagraph. Such attes-
tation shall be subject to enforcement 
under subparagraph (H) and, where 
applicable, shall be deemed material 
to payments from the Federal Govern-
ment received by the group health 
plan or health insurance issuer. 
‘‘(V) 
Regulations 
promulgated 
pursuant to this section shall provide 
that: 
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‘‘(aa) The Secretary shall 
audit the three machine-readable 
files required by subparagraph 
(E)(ii) posted by no fewer than 
20 group health plans or health 
insurance issuers. 
‘‘(bb) 
The 
Secretary 
of 
Labor shall audit the three ma-
chine-readable files required by 
subparagraph (E)(ii) posted by 
no fewer than 200 group health 
plans or service providers fur-
nishing third-party administrator 
services to a group health plan. 
‘‘(cc) Findings, conclusions, 
and enforcement actions taken 
based on audits of the machine- 
readable files shall be reported 
annually to Congress no later 
than July 1 of the calendar year 
during which the files were au-
dited. Such report to Congress 
shall be accessible to the public. 
‘‘(iv) USER GUIDE.—Each health plan 
shall make available to the public instruc-
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tions written in plain language explaining 
how individuals may search for information 
described in clause (ii) in files submitted in 
accordance with clause (iii). 
‘‘(F) DEFINITIONS.—In this paragraph: 
‘‘(i) PARTICIPATING PROVIDER.—The 
term ‘participating provider’ has the mean-
ing given such term in section 2799A–1 of 
the Public Health Service Act. 
‘‘(ii) IN-NETWORK
RATE.—The term 
‘in-network rate’ means, with respect to a 
health plan and an item or service fur-
nished by a provider that is a participating 
provider with respect to such plan and 
item or service, the contracted rate in ef-
fect between such plan and such provider 
for such item or service. If the rate is 
based on an algorithm, percentage of an-
other amount, or other formula or criteria, 
the health plan also shall disclose such al-
gorithm, percentage, formula, or criteria as 
set forth in its contract and any other 
terms, schedules, exhibits, data, or other 
information referenced in any such con-
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tract as shall be required to determine and 
disclose the negotiated rate. 
‘‘(G) APPLICABILITY
TO
ACCOUNTABLE 
CARE
ORGANIZATIONS.—An applicable ACO 
participating in the Medicare Shared Savings 
Program, as defined in Section 1899 of the So-
cial Security Act (42 U.S.C. 1395jjj), shall be 
subject to the requirements of this paragraph 
as if such applicable ACO is a group health 
plan or health insurance issuer. 
‘‘(H) ENFORCEMENT.— 
‘‘(i) IN
GENERAL.—Each year, the 
Secretary shall audit the three machine- 
readable files required by subparagraph 
(E)(ii) posted by no fewer than 20 group 
health plans or health insurance issuers. 
‘‘(ii) NOTIFICATION
AND
REQUEST 
FOR CORRECTIVE ACTION.—In the case of 
a health plan that fails to comply with the 
requirements of this subsection, not later 
than 30 days after the date on which the 
Secretary determines such failure exists, 
the Secretary shall submit to such health 
plan a notification of such determination, 
which shall include a request for a correc-
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tive action plan to comply with such re-
quirements. 
‘‘(iii) CIVIL MONETARY PENALTY.—A 
health plan that has received a request for 
a corrective action plan under clause (ii) 
and fails to comply with the requirements 
of this subsection by the date that is 90 
days after such request is made shall be 
subject to a civil monetary penalty of an 
amount specified by the Secretary for each 
day (beginning with the day on which the 
Secretary first determined that such lab-
oratory was failing to comply with such 
paragraph) during which such failure was 
ongoing. Such amount shall not exceed 
$300 per member per day or $10,000,000, 
whichever is lesser. 
‘‘(I) RULEMAKING.—The Secretary shall 
implement subparagraphs (E) through (H) 
through notice and comment rulemaking in ac-
cordance with section 553 of title 5, United 
States Code.’’. 
(c) EFFECTIVE DATE.— 
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(1) IN GENERAL.—The amendments made by 
subsections (a) and (b) shall apply beginning Janu-
ary 1, 2026. 
(2) CONTINUED APPLICABILITY OF RULES FOR 
PREVIOUS
YEARS.—Nothing in the amendments 
made by this section may be construed as affecting 
the applicability of the rule entitled ‘‘Transparency 
in Coverage’’ published by the Department of the 
Treasury, the Department of Labor, and the De-
partment of Health and Human Services on Novem-
ber 12, 2020 (85 Fed. Reg. 72158) before January 
1, 2026. 
SEC. 7. INCREASING GROUP HEALTH PLAN ACCESS TO 
HEALTH DATA. 
(a) GROUP HEALTH PLAN ACCESS TO INFORMA-
TION.— 
(1) IN
GENERAL.—Paragraph (2) of section 
408(b) of the Employee Retirement Income Security 
Act of 1974 (29 U.S.C. 1108(b)) is amended by 
adding at the end the following new subparagraphs: 
‘‘(C) No contract or arrangement for serv-
ices, and no extension or renewal of such con-
tract or arrangement, between a group health 
plan (as that term is defined in section 733(a) 
of this title) and party in interest, including a 
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health care provider (which for purposes of this 
subparagraph, includes a health care facility), 
network or association of providers, service pro-
vider offering access to a network of providers, 
third-party administrator, or pharmacy benefit 
manager (collectively referred to as ‘Covered 
Service Providers’), is reasonable within the 
meaning of this paragraph unless such contract 
or arrangement— 
‘‘(i) allows the responsible plan fidu-
ciary (as that term is defined in subpara-
graph (B)(ii)(I)(ee)) access to all claims 
and encounter information or data, and 
any documentation supporting claim pay-
ments, including, but not limited to, med-
ical records and policy documents, or infor-
mation or data described in section 
724(a)(1)(B) to— 
‘‘(I) enable such entity to comply 
with the terms of the plan and any 
applicable law; and 
‘‘(II) determine the accuracy or 
reasonableness of payment; and 
‘‘(ii) does not— 
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‘‘(I) unreasonably limit or delay 
access, as determined by the Secretary 
but in any event not longer than 15 
days, to such information or data; 
‘‘(II) limit the volume of claims 
and encounter information or data 
that the group health plan, the plan 
sponsor, the plan administrator, or a 
business associate of such plan may 
access during an audit or pursuant to 
any request for such information or 
data; 
‘‘(III) limit the disclosure of pric-
ing terms for value-based payment ar-
rangements or capitated payment ar-
rangements, including— 
‘‘(aa) payment calculations 
and formulas; 
‘‘(bb) quality measures; 
‘‘(cc) contract terms; 
‘‘(dd) payment amounts; 
‘‘(ee) measurement periods 
for all incentives; and 
‘‘(ff) other payment meth-
odologies used by an entity, in-
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cluding a health care provider 
(including a health care facility), 
network or association of pro-
viders, service provider offering 
access to a network of providers, 
third-party 
administrator, 
or 
pharmacy benefit manager; 
‘‘(IV) limit the disclosure of over-
payments and overpayment recovery 
terms; 
‘‘(V) limit the right of the group 
health plan, the plan sponsor, or the 
plan administrator of such plan to se-
lect an auditor or define audit scope 
or frequency; 
‘‘(VI) otherwise limit or unduly 
delay the group health plan, the plan 
sponsor, the plan administrator, or a 
business associate of such plan from 
accessing claims and encounter infor-
mation or data in a daily batch; 
‘‘(VII) limit the disclosure of fees 
charged to the group health plan re-
lated to plan administration and 
claims processing, including renegoti-
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ation fees, access fees, repricing fees, 
or enhanced review fees; 
‘‘(VIII) limit the right of the 
group health plan, the plan sponsor, 
or the plan administrator to request 
action on any suspect claim payments; 
or 
‘‘(IX) limit public disclosure of 
de-identified or aggregate information. 
‘‘(D)(i) Covered Service Providers shall 
provide information or data under this para-
graph in a manner consistent with the privacy 
and security regulations promulgated under the 
Health Insurance Portability and Accountability 
Act (referred to in this subparagraph as 
‘HIPAA’). 
‘‘(ii) A group health plan that receives a 
disclosure from a party in interest pursuant to 
subparagraph (B) or (C) shall comply with the 
privacy and security regulations promulgated 
under HIPAA. 
‘‘(iii) Nothing in this subparagraph shall 
be construed to modify the requirements for the 
creation, receipt, maintenance, or transmission 
of protected health information under the 
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HIPAA privacy regulation (as defined in section 
1180(b)(3) of the Social Security Act) as they 
apply directly or indirectly to an entity pursu-
ant to this paragraph. 
‘‘(iv) This subparagraph shall not be read 
to abridge or limit the disclosure requirements 
under this paragraph or to impose additional 
privacy or security requirements on Covered 
Service Providers or plan sponsors. 
‘‘(E) A group health plan receiving infor-
mation or data under this paragraph may dis-
close such information only in a manner that is 
consistent with the Health Insurance Port-
ability and Accountability Act (HIPAA) and the 
privacy and security regulations promulgated 
thereunder, regardless of their direct or indirect 
applicability to the plan or any entities that 
could be or are business associates. 
‘‘(F) Information made available under 
this section shall conform to the following 
standards: 
‘‘(i) All claims from a healthcare pro-
vider shall be made to the group health 
plan in accordance with transaction stand-
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ards adopted by regulation under HIPAA, 
as follows: 
‘‘(I) Institutional, professional, 
and dental claims shall be in ASC 
X12N 837 format or any subsequent 
standard. 
‘‘(II) Pharmacy claims shall be in 
the National Council for Prescription 
Drug Programs (NCPDP) format or 
any subsequent standard. 
‘‘(III) The files shall be unmodi-
fied copies of the files sent from the 
provider. In the event that paper 
claims are sent by the provider, they 
shall be converted to the appropriate 
standard electronic format. Files shall 
be accessible to the plan at no cost to 
the group health plan. 
‘‘(ii) All claim payment (or EFT, elec-
tronic funds transfer) and electronic remit-
tance advice (ERA) notices sent by a Cov-
ered Service Provider shall be made avail-
able to the group health plan as ASC 
X12N 835 files in accordance with stand-
ards adopted by regulation under HIPAA. 
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The files shall be unmodified copies of the 
files sent by the Covered Service Provider 
to the healthcare provider. Files shall be 
accessible at no cost to the group health 
plan. 
‘‘(iii) The contractual terms con-
taining calculation formulae, pricing meth-
odologies, and other information used to 
determine the dollar value of reimburse-
ment. 
‘‘(iv) All non-claim costs shall be 
itemized and made available to the group 
health plan in real time through a web- 
based portal, through an API, and through 
a downloadable CSV file. 
‘‘(G) The Secretary shall implement sub-
paragraphs (C) through (F) through notice and 
comment rulemaking in accordance with section 
553 of title 5, United States Code.’’. 
(2) CIVIL
ENFORCEMENT.—Subsection (c) of 
section 502 of such Act (29 U.S.C. 1132) is amend-
ed by adding at the end the following new para-
graph: 
‘‘(13) In the case of an agreement between a 
group health plan (as defined in section 733(a)), the 
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plan sponsor of such plan (as defined in section 
3(16)(B)), or the plan administrator of such plan 
(as defined in section 3(16)(A)) and a health care 
provider (which, for purposes of this paragraph, in-
cludes a health care facility), network or association 
of providers, service provider offering access to a 
network or association of providers, third-party ad-
ministrator, or pharmacy benefit manager, that vio-
lates the provisions of section 724, the Secretary 
may assess a civil penalty against such provider, net-
work or association, service provider offering access 
to a network or association of providers, third-party 
administrator, pharmacy benefit manager, or other 
service provider in the amount of $10,000 for each 
day during which such violation continues. Such 
penalty shall be in addition to other penalties as 
may be prescribed by law.’’. 
(3) EXISTING PROVISIONS VOID.—Section 410 
of such Act (29 U.S.C. 1110) is amended by adding 
at the end the following: 
‘‘(c) Any provision in an agreement or instrument 
shall be void as against public policy if such provision— 
‘‘(1) unduly delays or limits a group health plan 
(as defined in section 733(a)), the plan sponsor of 
such plan (as defined in section 3(16)(B)), or the 
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plan administrator of such plan (as defined in sec-
tion 3(16)(A)) from accessing the claims and en-
counter information or data described in section 
724(a)(1)(B); or 
‘‘(2) violates the requirements of section 
408(b)(2)(C).’’. 
(4) TECHNICAL
AMENDMENT.—Clause (i) of 
section 408(b)(2)(B) of such Act is amended by 
striking ‘‘this clause’’ and inserting ‘‘this para-
graph’’. 
(b) UPDATED ATTESTATION FOR PRICE AND QUAL-
ITY INFORMATION.—Section 724(a)(3) of the Employee 
Retirement Income Security Act of 1974 (29 U.S.C. 
1185m(a)(3)) is amended to read as follows: 
‘‘(3) ATTESTATION.— 
‘‘(A) IN
GENERAL.—Subject to subpara-
graph (C), a group health plan or health insur-
ance issuer offering group health insurance cov-
erage shall annually submit to the Secretary an 
attestation that such plan or issuer of such cov-
erage is in compliance with the requirements of 
this subsection. Such attestation shall also in-
clude a statement verifying that— 
‘‘(i) the information or data described 
under subparagraphs (A) and (B) of para-
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graph (1) is available upon request and 
provided to the group health plan, the plan 
sponsor, the plan administrator, or the 
business associate of such plan, or the 
issuer in a timely manner; and 
‘‘(ii) there are no terms in the agree-
ment under such paragraph (1) that di-
rectly or indirectly restrict or unduly delay 
a group health plan, the plan sponsor, the 
plan administrator, a business associate of 
such plan, or the issuer from auditing, re-
viewing, or otherwise accessing such infor-
mation. 
‘‘(B) LIMITATION ON SUBMISSION.—Sub-
ject to clause (ii), a group health plan or issuer 
offering group health insurance coverage may 
not enter into an agreement with a third-party 
administrator or other service provider to sub-
mit the attestation required under subpara-
graph (A). 
‘‘(C) EXCEPTION.—In the case of a group 
health plan or issuer offering group health in-
surance coverage that is unable to obtain the 
information or data needed to submit the attes-
tation required under subparagraph (A), such 
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plan or issuer may submit a written statement 
in lieu of such attestation that includes— 
‘‘(i) an explanation of why such plan 
or issuer was unsuccessful in obtaining 
such information or data, including wheth-
er such plan, the plan sponsor, or the plan 
administrator or issuer was limited or pre-
vented from auditing, reviewing, or other-
wise accessing such information or data; 
‘‘(ii) a description of the efforts made 
by the group health plan, the plan sponsor, 
or the plan administrator to remove any 
gag clause provisions from the agreement 
under paragraph (1); and 
‘‘(iii) a description of any response by 
the third-party administrator or other serv-
ice provider with respect to efforts to com-
ply with the attestation requirement under 
subparagraph (A), including the name of 
the third-party administrator or other serv-
ice provider.’’. 
(c) EFFECTIVE DATE.—The amendments made by 
subsections (a) and (b) shall apply with respect to a plan 
beginning with the first plan year that begins on or after 
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the date that is 1 year after the date of enactment of this 
Act. 
SEC. 8. OVERSIGHT OF ADMINISTRATIVE SERVICE PRO-
VIDERS. 
(a) ERISA AMENDMENTS.— 
(1) IN GENERAL.—Subpart B of part 7 of sub-
title B of the Employee Retirement Income Security 
Act of 1974 (29 U.S.C. 1021 et seq.) is amended by 
adding at the end the following: 
‘‘SEC. 726. OVERSIGHT OF ADMINISTRATIVE SERVICE PRO-
VIDERS. 
‘‘(a) IN GENERAL.—For plan years beginning on or 
after the date that is 2 years after the date of enactment 
of this section, no agreement between a group health plan 
(as defined in section 733(a)), the plan sponsor of such 
plan (as defined in section 3(16)(B)), the plan adminis-
trator of such plan (as defined in section 3(16)(A)), or 
a business associate of such plan (as defined in section 
160.103 of title 45, Code of Federal Regulations), (or 
health insurance issuer offering group health insurance 
coverage in connection with such a plan), and a health 
care provider, network or association of providers, third- 
party administrator, service provider offering access to a 
network of providers, pharmacy benefit managers, or any 
other third party (each referred to as a ‘health plan service 
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provider’) is permissible if such agreement limits (or 
delays beyond the applicable reporting period described in 
subsection (b)(1)) the disclosure of information to group 
health plans in such a manner that prevents such plan, 
issuer, or entity from providing the information described 
in subsection (b). 
‘‘(b) REQUIRED DISCLOSURES.— 
‘‘(1) CONTENTS
AND
FREQUENCY.—With re-
spect to plan years beginning on or after the date 
that is 2 years after the date of enactment of this 
section, not less frequently than quarterly, a health 
plan service provider shall provide to the group 
health plan or health insurance issuer the following 
information at no cost to the group health plan or 
health insurance issuer: 
‘‘(A) The information described in section 
724(a)(1)(B). 
‘‘(B) Any contractual and subcontractual 
calculation methodologies, pricing or fee sched-
ules, or other formulae used to determine reim-
bursement amounts to providers and sub-
contractors, including methodologies, schedules, 
fee structures, and any applied adjustments or 
modifiers, with such information provided in a 
manner sufficiently detailed to enable the group 
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health plan or health insurance issuer to accu-
rately assess, verify, and ensure compliance 
with the terms of any contractual and sub-
contractual agreement governing the reimburse-
ment amounts. 
‘‘(C) The total amount received or ex-
pected to be received by the health plan service 
provider or its subcontractors in provider or 
supplier rebates, fees, alternative discounts, and 
all other remuneration including amounts held 
in escrow or variance accounts that has been 
paid or is to be paid for claims incurred and 
administrative services including data sales or 
network payments. 
‘‘(D) The total amount paid or expected to 
be paid by the health plan service provider or 
to subcontractors in rebates, fees, contractual 
arrangements, and all other remuneration that 
has been paid or is expected to be paid for ad-
ministrative and other services. 
‘‘(E) All payment data and reconciliation 
information related to alternative compensation 
arrangements including accountable care orga-
nizations, value-based programs, shared savings 
programs, incentive compensation, bundled pay-
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ments, capitation arrangements, performance 
payments, and any other reimbursement or pay-
ment models, where the group health plan or 
health insurance issuer paid fees, incurred obli-
gations, or made payments in connection with 
the group health plan related to such arrange-
ments. 
‘‘(2) PRIVACY REQUIREMENTS.— 
‘‘(A) IN
GENERAL.—Health plan service 
providers shall provide the information or data 
under paragraph (1) consistent with the pri-
vacy, security, and breach notification regula-
tions at parts 160 and 164 of title 45, Code of 
Federal Regulations, promulgated under sub-
title F of the Health Insurance Portability and 
Accountability Act of 1996, subtitle D of the 
Health Information Technology for Clinical 
Health Act of 2009, and section 1180 of the 
Social Security Act, and shall restrict the use 
and disclosure of such information according to 
such privacy, security, and breach notification 
regulations. An entity that receives a disclosure 
from a party in interest pursuant to subpara-
graph (B) or (C) shall comply with the privacy 
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and security regulations promulgated under 
HIPAA. 
‘‘(B) RESTRICTIONS.—A group health plan 
shall comply with section 164.504(f) of title 45, 
Code of Federal Regulations (or a successor 
regulation), and a plan sponsor shall act in ac-
cordance with the terms of the agreement de-
scribed in such section. 
‘‘(C) RULE OF CONSTRUCTION.—Nothing 
in this section shall be construed to modify the 
requirements for the creation, receipt, mainte-
nance, or transmission of protected health in-
formation under the HIPAA privacy regulations 
(45 C.F.R. parts 160 and 164, subparts A and 
E). 
‘‘(3) DISCLOSURE AND REDISCLOSURE.— 
‘‘(A) IN GENERAL.—A group health plan 
receiving information under paragraph (1) may 
disclose such information only— 
‘‘(i) to the entity from which the in-
formation was received or to that entity’s 
business associates or to the group health 
plan’s business associates as defined in 
section 160.103 of title 45, Code of Fed-
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eral Regulations (or successor regulations); 
or 
‘‘(ii) as permitted by the HIPAA Pri-
vacy Rule (45 C.F.R. parts 160 and 164, 
subparts A and E). 
‘‘(B) AVAILABILITY OF INFORMATION.—To 
the extent the information required by this sub-
section is made available to the health insur-
ance issuer offering group health insurance in 
connection with a group health plan, the health 
insurance issuer shall make such information 
available, at the same time, in the same format, 
and at no cost, to the group health plan. 
‘‘(C) FAILURE TO PROVIDE.—The obliga-
tion to provide information pursuant to this 
subsection shall exist notwithstanding the pres-
ence of any formal data-sharing agreement be-
tween the parties. Failure to provide the re-
quired information as specified shall constitute 
a violation of this Act and the Secretary shall 
initiate enforcement action under section 502 
within 90 days of becoming aware of a violation 
of this section, except that nothing in this sec-
tion shall be construed to limit the Secretary’s 
existing authority under the Act. 
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‘‘(4) DATA FORMAT STANDARDS.—All data and 
information provided pursuant to this subsection 
shall comply with the following standards: 
‘‘(A) All claims from a healthcare provider 
shall be made to the group health plan in ac-
cordance with transactions standards adopted 
under HIPAA, as follows: 
‘‘(i) Institutional, professional, and 
dental claims and adjustments to these 
claims shall be in ASC X12N 837 format, 
as transmitted by the provider, or, in the 
case of paper claims, converted to the ASC 
X12N 837 electronic format. 
‘‘(ii) Prescription drug claims shall be 
in the National Council for Prescription 
Drug Programs (NCPDP) format, as 
transmitted by the provider, or in the case 
of paper claims, converted to the NCPDP 
electronic format. 
‘‘(iii) Such data shall be provided at 
no cost to the group health plan. 
‘‘(B) All claim payment (or EFT, elec-
tronic funds transfer) and electronic remittance 
advice (ERA) information sent by a health plan 
service provider shall be provided to the group 
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health plan or health insurance issuer in the 
ASC X12N 835 format in accordance with 
transaction standards adopted under HIPAA, 
unmodified from the form in which it was 
transmitted to the healthcare provider. Such in-
formation shall be provided at no cost to the 
group health plan or health insurance issuer. 
‘‘(C) The Secretary may modify the stand-
ards set forth in this paragraph as necessary to 
align with any changes adopted by the Sec-
retary of Health and Human Services pursuant 
to the authority provided under section 1173 of 
the Social Security Act (42 U.S.C. 1320d–2). 
‘‘(c) PROHIBITED CONTRACTUAL PROVISIONS.—Any 
provision in an agreement between a group health plan, 
the plan sponsor, the plan administrator, or a business 
associate of such plan or a health insurance issuer and 
a health plan service provider that unduly delays or limits 
a group health plan’s or health insurance issuer’s access 
to information described in this section or that restricts 
the format or timing of the provision of such information 
in a manner that is inconsistent with the requirements of 
this section shall be prohibited and, if a group health plan 
or health insurance issuer enters into such agreement, 
shall be deemed void as against public policy. 
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‘‘(d) PENALTIES FOR NON-COMPLIANCE.—Any fail-
ure by a health plan service provider to comply with the 
requirements of this section shall result in the imposition 
of a civil penalty of $100,000 for each day the violation 
continues, in addition to any other penalties prescribed by 
law. 
‘‘(e) REGULATIONS.—The Secretary shall implement 
this section through notice and comment rulemaking in 
accordance with section 553 of title 5, United States 
Code.’’. 
(2) PENALTY.— 
(A) IN GENERAL.—Section 502(a) of the 
Employee Retirement Income Security Act of 
1974 (29 U.S.C. 1132(a)) is amended by add-
ing at the end the following new paragraph: 
‘‘(14) The Secretary may assess a civil penalty 
against any person of $100,000 per day for each vio-
lation by any person of section 726.’’. 
(B) TECHNICAL AMENDMENT.—Paragraph 
(6) of section 502(a) of the Employee Retire-
ment Income Security Act of 1974 (29 U.S.C. 
1132(a)) is amended by striking ‘‘or (9)’’ and 
inserting it with the phrase ‘‘(9), (13), or 
(14)’’. 
(b) PHSA AMENDMENTS.— 
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(1) IN GENERAL.—Part D of title XXVII of the 
Public Health Service Act (42 U.S.C. 300gg–111 et 
seq.) is amended by adding at the end the following: 
‘‘SEC. 2799A–11. OVERSIGHT OF ADMINISTRATIVE SERVICE 
PROVIDERS. 
‘‘(a) IN GENERAL.—For plan years beginning on or 
after the date that is 1 year after the date of enactment 
of this section, no agreement between a group health plan 
that is a self-funded, non-Federal governmental plan, as 
defined in section 2791(d)(8)(C) (42 U.S.C. 300gg– 
91(d)(8)(C)), and a health care provider, network or asso-
ciation of providers, third-party administrator, service pro-
vider offering access to a network of providers, pharmacy 
benefit managers, or any other third party (each referred 
to in this section as a ‘health plan service provider’) is 
permissible if such agreement limits (or delays beyond the 
applicable reporting period described in subsection (b)(1)) 
the disclosure of information to group health plans in such 
a manner that prevents such plan, issuer, or entity from 
providing the information described in subsection (b). 
‘‘(b) REQUIRED DISCLOSURES.— 
‘‘(1) CONTENTS
AND
FREQUENCY.—With re-
spect to plan years beginning on or after the date 
that is 1 year after the date of enactment of this 
section, not less frequently than quarterly, a health 
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plan service provider shall provide to the group 
health plan that is a self-funded, non-Federal gov-
ernmental plan the following information at no cost 
to the plan: 
‘‘(A) The information described in section 
2799A–9(a)(1)(B) 
(42 
U.S.C. 
300gg– 
119(a)(1)(B)). 
‘‘(B) Any contractual and subcontractual 
calculation methodologies, pricing or fee sched-
ules, or other formulae used to determine reim-
bursement amounts to providers and sub-
contractors, including methodologies, schedules, 
fee structures, and any applied adjustments or 
modifiers, with such information provided in a 
manner sufficiently detailed to enable the group 
health plan to accurately assess, verify, and en-
sure compliance with the terms of any contrac-
tual and subcontractual agreement governing 
the reimbursement amounts. 
‘‘(C) The total amount received or ex-
pected to be received by the health plan service 
provider or its subcontractors in provider or 
supplier rebates, fees, alternative discounts, and 
all other remuneration including amounts held 
in escrow or variance accounts that has been 
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paid or is to be paid for claims incurred and 
administrative services including data sales or 
network payments. 
‘‘(D) The total amount paid or expected to 
be paid by the health plan service provider or 
to subcontractors in rebates, fees, contractual 
arrangements, and all other remuneration that 
has been paid or is expected to be paid for ad-
ministrative and other services. 
‘‘(E) All payment data and reconciliation 
information related to alternative compensation 
arrangements including accountable care orga-
nizations, value-based programs, shared savings 
programs, incentive compensation, bundled pay-
ments, capitation arrangements, performance 
payments, and any other reimbursement or pay-
ment models, where the group health plan paid 
fees, incurred obligations, or made payments in 
connection with the group health plan related to 
such arrangements. 
‘‘(2) PRIVACY REQUIREMENTS.— 
‘‘(A) IN
GENERAL.—Health plan service 
providers shall provide the information or data 
under paragraph (1) consistent with the pri-
vacy, security, and breach notification regula-
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same format as the advanced explanation of benefits 
required by subsection (f) to enable comparison) in-
cluding the following: 
‘‘(A) Whether or not the provider or facil-
ity is a participating provider or a participating 
facility with respect to the plan with respect to 
the furnishing of such item or service. 
‘‘(B) An itemized explanation of benefits 
that includes the following: 
‘‘(i) A plain language description of 
each item or service. 
‘‘(ii) All applicable billing codes for 
each item or service, including modifiers, 
using standard and commonly recognized 
billing code sets that are clearly identified. 
‘‘(iii) The amount the plan is respon-
sible for paying for each item or service. 
‘‘(iv) The amount of any cost-sharing 
for which the participant or beneficiary is 
responsible for each item or service (as of 
the date of such notification). 
‘‘(v) The amount that the participant 
or beneficiary has incurred toward meeting 
the limit of the financial responsibility (in-
cluding with respect to deductibles and 
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