I 
116TH CONGRESS 
2D SESSION 
H. R. 6004 
To amend title XXVII of the Public Health Service Act to require the 
Secretary of Health and Human Services to establish a grant program 
for purposes of facilitating State efforts to establish or maintain all- 
payer claims databases, and for other purposes. 
IN THE HOUSE OF REPRESENTATIVES 
FEBRUARY 27, 2020 
Mr. LIPINSKI introduced the following bill; which was referred to the Com-
mittee on Energy and Commerce, and in addition to the Committee on 
Education and Labor, for a period to be subsequently determined by the 
Speaker, in each case for consideration of such provisions as fall within 
the jurisdiction of the committee concerned 
A BILL 
To amend title XXVII of the Public Health Service Act 
to require the Secretary of Health and Human Services 
to establish a grant program for purposes of facilitating 
State efforts to establish or maintain all-payer claims 
databases, and for other purposes. 
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled, 
SECTION 1. SHORT TITLE; FINDINGS. 
(a) SHORT TITLE.—This Act may be cited as the 
‘‘Transparency and Accountability in Health Care Costs 
and Prices Act of 2020’’. 
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(b) FINDINGS.—Congress finds the following: 
(1) According to official estimates published by 
the Centers for Medicare & Medicaid Services, 
Americans spent a total of $3.6 trillion on health 
care in 2018, or $11,172 per person. 
(2) Spending on hospital care services reached 
$1.2 trillion in 2018 and rose by 4.5 percent from 
the previous year. This growth occurred even as 
Americans made fewer hospital visits because of 
growth in hospital prices. 
(3) Spending on physician visits and clinical 
services reached $725.6 billion in 2018 and rose by 
4.1 percent from the previous year. 
(4) Spending on prescription drugs reached 
$335 billion in 2018 and rose by 2.5 percent from 
the previous year. 
(5) According to a 2019 analysis of a subset of 
commercial insurance claims by the independent, 
non-partisan Health Care Cost Institute, prices for 
common medical services could vary up to 25 times 
between different metro areas and up to 39 times 
for the same service within the same metro area. 
(6) A 2015 analysis of a subset of commercial 
insurance claims by Yale, University of Pennsyl-
vania, Carnegie Mellon, and MIT researchers found 
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that even within one hospital, prices for certain com-
mon services like lower limb MRIs, knee replace-
ments, and colonoscopies could vary by 23.5 percent 
on average depending on which insurer covered the 
patient. 
(7) Information about contracts between pro-
viders and insurers available to researchers, policy-
makers, and the public is limited or incomplete be-
cause these contracts frequently prohibit disclosure 
of information about how providers are paid. 
(8) All-payer claims databases (APCDs) are 
large-scale databases increasingly adopted by States 
to collect health care claims data across different 
payers such as private insurers, government em-
ployee health plans, Medicare, and Medicaid. 
(9) APCD data can be shared with vetted and 
authorized users to make it easier to track trends in 
health care prices, create tools for consumers to 
check price and quality, assist employers and health 
plans in making more informed decisions when de-
veloping employer-sponsored health plans, test new 
ideas for holding down health care costs, and guide 
policymakers in developing health care policy. 
(10) In 2019, the independent, non-partisan 
RAND Corporation published the first broad-based 
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study reporting prices paid by private health plans 
to hospitals identified by name. This important 
study tracked important disparities in price trends 
across the nation, with relative prices increasing rap-
idly from 2015 to 2017 for hospitals in some States, 
while falling in others. This work was made possible 
in part through the use of data from APCDs in New 
Hampshire and Colorado. 
(11) Since 2015, Oregon has used data from its 
APCD to review insurers’ proposed premium rates, 
including determining whether or not proposed pre-
miums are excessive. Oregon has also used its 
APCD to create an annual report on hospital reim-
bursement variations from different insurers. 
(12) Minnesota and Virginia have used data 
from their APCDs to shine a spotlight on spending 
for low-value—possibly even unnecessary—medical 
services. 
(13) Washington State has used data from its 
APCD 
to 
create 
the 
Washington 
HealthCareCompare tool that helps patients learn 
about local prices for medical services at local doc-
tors’ offices, hospitals, and outpatient centers, and 
puts those prices in context by highlighting what 
kinds of prices can be considered typical, low, or 
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