110 
shall apply to a civil money penalty under this para-
graph in the same manner as such provisions apply 
with respect to a penalty or proceeding under section 
1128A(a).’’; and 
(2) by adding at the end the following new sub-
section: 
‘‘(j) PROTECTIONS AGAINST EXCESSIVE OUT-OF- 
NETWORK CHARGES FOR EMERGENCY SERVICES.— 
‘‘(1) IN
GENERAL.—If items or services to 
screen or treat an emergency medical condition are 
furnished under this section in a participating hos-
pital with respect to an individual and the individual 
has not, directly or through a health insurance 
issuer, group health plan, or other third party, nego-
tiated a payment rate for such items and services, 
subject to paragraph (2), the charges imposed for 
such items and services may not be in excess of the 
following: 
‘‘(A) PHYSICIANS’ AND
OTHER
PROFES-
SIONAL SERVICES.—For physicians’ services or 
services of a health care provider to which sec-
tion 223(e)(9) of the Internal Revenue Code of 
1986 
applies 
(and 
including 
drugs 
and 
biologicals furnished in conjunction with and 
billed as part of such services), the lesser of— 
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‘‘(i) the cash price for such services 
posted pursuant to such section; or 
‘‘(ii) 85 percent of the usual, cus-
tomary, and reasonable (UCR) charge for 
such services, as determined under rules 
established by the department of insurance 
for the State in which the services are fur-
nished. 
‘‘(B) HOSPITAL SERVICES.—For inpatient 
and outpatient hospital services for which pay-
ment rates are established under this title (and 
including drugs and biologicals furnished in 
conjunction with and billed as part of such 
services), the lesser of— 
‘‘(i) the cash price for such services 
posted pursuant to section 223(e)(9) of the 
Internal Revenue Code of 1986; or 
‘‘(ii) 110 percent of the payment rate 
applicable to such services in the case of 
an individual entitled to benefits under 
part A and enrolled under part B. 
‘‘(C) 
DRUGS
AND
BIOLOGICALS.—For 
drugs and other pharmaceuticals furnished to 
which a previous subparagraph does not apply, 
the lesser of— 
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‘‘(i) twice the acquisition cost to the 
hospital or other provider for the dose in-
volved; or 
‘‘(ii) the acquisition cost to the hos-
pital or other provider plus $250. 
The dollar amount in clause (ii) shall be in-
creased from year to year (beginning with the 
year after the first year in which this subsection 
applies) by the same percentage as the percent-
age increase in the consumer price index for all 
urban consumers (all items; U.S. city average) 
for the year involved (as determined by the Sec-
retary). Any such dollar amount as so increased 
that is not a multiple of $5 shall be rounded to 
the nearest multiple of $5 (or, if a multiple of 
$2.50, to the next highest multiple of $5). 
‘‘(D) OTHER ITEMS AND SERVICES.—For 
any other items or services, the lesser of— 
‘‘(i) the cash price for such items and 
services 
posted 
pursuant 
to 
section 
223(e)(9) of the Internal Revenue Code of 
1986; or 
‘‘(ii) 110 percent of the payment basis 
that would be applicable to payment for 
such items and services under this title in 
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the case of an individual entitled to bene-
fits under part A and enrolled under part 
B. 
‘‘(2) SPECIAL RULE FOR ITEMS AND SERVICES 
FURNISHED AS A BUNDLE.—In the case of items 
and services for which there is a single price for a 
group or bundle of such items and services, the max-
imum charge permitted under paragraph (1) may 
not exceed the lesser of— 
‘‘(A) the price charged for such bundled 
services; or 
‘‘(B) the aggregate of the maximum 
charges permitted under paragraph (1) with re-
spect to items and services included in such 
bundle.’’. 
(b) EFFECTIVE DATE.—The amendments made by 
this section shall apply to charges imposed for items and 
services furnished on or after January 1, 2017. 
SEC. 502. PUBLISHING OF CASH PRICE FOR CARE PAID 
THROUGH HEALTH SAVINGS ACCOUNTS. 
(a) HEALTH SAVINGS ACCOUNTS.—Section 223(f) of 
the Internal Revenue Code of 1986 is amended by adding 
at the end the following new paragraph: 
‘‘(9) CASH
PRICE
TRANSPARENCY
REQUIRED 
FOR PAYMENTS TO HEALTH CARE PROVIDERS.— 
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‘‘(A) IN GENERAL.—A payment to a health 
care provider with respect to the furnishing of 
health care items and services by such provider 
shall not be treated as a qualified medical ex-
pense unless health care provider provides for 
continuing disclosure (such as through posting 
on a publicly accessible website) of the cash 
price the health care provider charges for the 
furnishing of such items and services. 
‘‘(B) FORM OF DISCLOSURE.—The disclo-
sure of prices under this subsection shall be in 
a form and manner specified by the Secretary 
of Health and Human Services, in consultation 
with the Secretary, and shall be designed— 
‘‘(i) to establish a single price for re-
lated items and services in a manner simi-
lar to the manner in which pricing and 
payment for such items and services is pro-
vided under the Medicare program under 
title XVIII of the Social Security Act, and 
‘‘(ii) to make it easy for consumers to 
compare the prices for similar items and 
services furnished by different providers. 
‘‘(C) FAILURE TO FURNISH SERVICES OR 
CHARGE
IN
EXCESS
OF
STATED
PRICE.—A 
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health care provider shall be treated as not 
meeting the requirement of subparagraph (A), 
in the case of items and services for which the 
provider is disclosing a cash price, if the pro-
vider— 
‘‘(i) refuses to furnish such items or 
services at the price listed, or 
‘‘(ii) charges more than the price list-
ed for the furnishing of the items and serv-
ices.’’. 
(b) ROTH HSA.—Section 530A(c)(4) of such Code, 
as added by this Act, is amended by adding at the end 
the following new subparagraph: 
‘‘(E) Section 223(f) (relating to cash price 
transparency required for payments to health 
care providers).’’. 
(c) ENFORCEMENT.—If the Secretary of Health and 
Human Services determines that a health care provider 
has not provided for continuing disclosure of the cash 
price of health care provider charges under section 
223(f)(9) of the Internal Revenue Code of 1986, the Sec-
retary may instruct the Secretary of the Treasury that 
payments made to such provider shall be not treated, for 
purposes of section 223 of the Internal Revenue Code of 
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1986, as an amount used for a qualified medical expense 
for a period of not to exceed 1 year. 
(d) EFFECTIVE DATE.—The amendments made by 
this section shall apply to taxable years beginning after 
December 31, 2016. 
SEC. 503. LIBERATING THE LOCAL PRACTICE OF HEALTH 
CARE. 
(a) WAIVING NATIONAL RESTRICTIONS ON PHYSI-
CIAN-OWNED FACILITIES.—Section 1877 of the Social Se-
curity Act (42 U.S.C. 1395nn) is amended by adding at 
the end the following new subsection: 
‘‘(j) WAIVER AUTHORITY.—A physician or other enti-
ty may apply to the Secretary to waive any provision of 
this section and the Secretary may waive such provision 
with respect to such physician or entity if the Secretary 
determines that such waiver would— 
‘‘(1) increase competition within the health care 
market; 
‘‘(2) reduce the costs of health care; and 
‘‘(3) increase the quality of health care.’’. 
(b) REMOVING CERTAIN STATE AND LOCAL LICEN-
SURE OR CERTIFICATION RESTRICTIONS.— 
(1) APPLICATION
FOR
WAIVER
OF
RESTRIC-
TIONS.—An individual who is required to be licensed 
or certified by a State as a condition of furnishing 
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items or services as a health care professional (as 
defined by the Secretary of Health and Human 
Services) may submit to the Secretary an application 
to waive any condition of such licensure or certifi-
cation. 
(2) STANDARD.—The Secretary may grant a 
waiver submitted under paragraph (1) if the Sec-
retary determines such waiver would— 
(A) increase competition within the health 
care market; 
(B) reduce the costs of health care; and 
(C) increase the quality of health care. 
(3) PREEMPTION.—In the case of a health care 
professional granted a waiver under paragraph (2), 
any requirement with respect to which such waiver 
is granted is preempted to the extent specified in 
such waiver. 
Æ 
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