Health Care Price Transparency: More Clarity for Patients and Consumers
This act aims to increase transparency in healthcare prices and insurance coverage, enabling citizens to more easily compare treatment costs. Hospitals will be required to disclose detailed price lists, and insurers to provide tools for estimating healthcare expenses. This will help individuals plan their healthcare spending and avoid financial surprises.
Key points
Hospitals must publicly disclose comprehensive price lists for services, including gross charges, payer-specific negotiated charges, de-identified minimum and maximum negotiated charges, and discounted cash prices.
Hospital price information must be available in plain language, free of charge, in a machine-readable format, and cover at least 300 common 'shoppable' services.
Health insurers will be required to provide online tools allowing individuals to estimate out-of-pocket costs for services from various providers, both in-network and out-of-network.
Insurer tools must show how much an individual will owe, factoring in accumulated amounts towards deductibles and out-of-pocket limits.
Hospitals failing to comply with price transparency requirements may face civil monetary penalties of up to $300 per day.
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