I 
118TH CONGRESS 
1ST SESSION H. R. 2861 
To require the Government Accountability Office to evaluate the effects of 
anticompetitive contracting clauses in contracts between health insurers 
and health care providers and to determine actions taken by the Federal 
Trade Commission and the Department of Justice relating to the use 
of such clauses in such contracts and to assess their ability to effectively 
enforce the Federal antitrust laws with respect to such use. 
IN THE HOUSE OF REPRESENTATIVES 
APRIL 25, 2023 
Mrs. SPARTZ introduced the following bill; which was referred to the Com-
mittee on Energy and Commerce, and in addition to the Committee on 
the Judiciary, for a period to be subsequently determined by the Speaker, 
in each case for consideration of such provisions as fall within the juris-
diction of the committee concerned 
A BILL 
To require the Government Accountability Office to evaluate 
the effects of anticompetitive contracting clauses in con-
tracts between health insurers and health care providers 
and to determine actions taken by the Federal Trade 
Commission and the Department of Justice relating to 
the use of such clauses in such contracts and to assess 
their ability to effectively enforce the Federal antitrust 
laws with respect to such use. 
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled, 
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SECTION 1. SHORT TITLE. 
This Act may be cited as the ‘‘Addressing Anti-Com-
petitive Health Care Contract Clauses Act’’. 
SEC. 2. GAO STUDY. 
(a) STUDY.—Not later than 18 months after the date 
of the enactment of this Act, the Comptroller General of 
the United States, in coordination with the Federal Trade 
Commission and the Assistant Attorney General of the 
Antitrust Division of the Department of Justice, shall 
carry out a study that— 
(1) evaluates the effect of anticompetitive con-
tract clauses known as anti-steering clauses, anti- 
tiering clauses, all-or-nothing clauses, and gag 
clauses in contracts between health insurers and 
health care providers, including the effects such con-
tracts have on consolidation in the health care indus-
try, prices paid by consumers for medical services, 
and consumer access to health care, 
(2) contains a list of all actions the Federal 
Trade Commission and the Department of Justice 
have taken directly or indirectly related to use of 
such contract clauses in contracts between health in-
surers and health care providers, 
(3) contains an assessment of whether the Fed-
eral Trade Commission and the Department of Jus-
tice have the resources and the capability to effec-
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tively enforce the Federal antitrust laws as applied 
to the use of such clauses in such contracts, and 
(4) includes recommendations for legislative or 
administrative actions if necessary to increase such 
resources. 
(b) REPORT.—The report containing the results of 
the study carried out under subsection (a) shall be sub-
mitted timely by the Comptroller General as follows: 
(1) To— 
(A) the Committee on Energy and Com-
merce, 
(B) the Committee on Ways and Means, 
(C) the Committee on Education and the 
Workforce, and 
(D) the Committee on the Judiciary, 
of the House of Representatives. 
(2) To— 
(A) The Committee on Health, Education, 
Labor, and Pensions, and 
(B) The Committee on the Judiciary, 
of the Senate. 
SEC. 3. DEFINITIONS. 
For purposes of this Act: 
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(1) ALL-OR-NOTHING CLAUSE.—The term ‘‘all- 
or-nothing clause’’ means a provision of a health 
care contract that requires— 
(A) a health insurance carrier or health 
plan administrator to include all members of a 
health care provider in a network plan; or 
(B) a health insurance carrier or health 
plan administrator to enter into an additional 
contract with an affiliate of the health care pro-
vider as a condition of entering into a contract 
with such health care provider. 
(2) ANTI-STEERING CLAUSE.—The term ‘‘anti- 
steering clause’’ means a provision of a health care 
contract that restricts the ability of a health insur-
ance carrier or a health plan administrator from en-
couraging an enrollee to obtain a health care service 
from a competitor of the hospital or health system, 
including offering incentives to encourage enrollees 
to utilize specific health care providers. 
(3) ANTI-TIERING
CLAUSE.—The term ‘‘anti- 
tiering clause’’ means a provision in a health care 
contract that— 
(A) restricts the ability of a health insur-
ance carrier or a health plan administrator to 
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introduce or modify a tiered network plan or 
assign health care providers into tiers; or 
(B) requires the health insurance carrier 
or health plan administrator to place all mem-
bers of a health care provider in the same tier 
of a tiered network plan. 
(4) GAG
CLAUSE.—The term ‘‘gag clause’’ 
means a provision of a health care contract that— 
(A) restricts the ability of a health insur-
ance carrier, a health plan administrator, or a 
health care provider to disclose a price or qual-
ity information, including the allowed amount, 
negotiated rates or discounts, fees for services, 
or any other claim-related financial obligations 
included in the provider contract to— 
(i) a governmental entity as author-
ized by law, 
(ii) its contractors or agents, 
(iii) an enrollee, 
(iv) a treating health care provider of 
an enrollee, 
(v) a plan sponsor, or 
(vi) potential eligible enrollees and 
plan sponsors; or 
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