Patients Deserve Price Tags Act
This bill, titled the Patients Deserve Price Tags Act, would expand and standardize price transparency across hospitals, laboratories, imaging providers, and ambulatory surgical centers (ASCs). It requires public disclosure of itemized standard charges, cash prices, and payer-specific negotiated charges for a wide set of services, along with a consumer-friendly format and a machine-readable data format. The Secretary of Health and Human Services would establish uniform reporting formats and oversee ongoing compliance, with annual monitoring and civil penalties for violators. The act also adds price transparency requirements specifically for clinical diagnostic laboratories, imaging services, and ASCs, with separate timelines and enforcement provisions. The overall goal is to help patients compare prices and shop for care, particularly for services that can be scheduled in advance (shoppable services). Key elements include: mandatory monthly public disclosure of charges by hospitals (and similar reporting by labs, imaging providers, and ASCs starting on set dates), a uniform data format, attestation by senior hospital officials, and penalties tied to noncompliance. The bill also clarifies that state price-transparency rules remain in effect unless they conflict with the Act. Effective dates range from 2026 (hospitals) to 2027 (labs, imaging, and ASCs).
Key Points
- 1Hospital price transparency requirements
- 2- Hospitals must publicly disclose all standard charges for every item and service, plus a consumer-friendly price list that includes many required elements (e.g., shoppable services, discounted cash price, payer-specific negotiated charges, and the range of negotiated prices).
- 3- At least 300 shoppable services must be shown (with CMS-listed shoppable services prioritized); over time, all shoppable services must be included.
- 4- Data must be presented in machine-readable (spreadsheet) format and in a consumer-friendly format, with updates as needed.
- 5- A senior hospital official must attest to the accuracy and completeness of the disclosures, and this attestation is treated as material to federal payment to the hospital.
- 6- Enforcement includes annual monitoring and civil penalties for noncompliance, with tiered per-day penalties scaling by hospital size.
- 7Uniform method and format
- 8- The Secretary must establish standard, uniform reporting formats by a target date (January 1, 2026 for hospitals; January 1, 2027 for other aspects), including machine-readable data and accessibility/usability standards.
- 9- The Secretary can require additional information beyond the core items to help consumers understand and compare prices.
- 10Clinial diagnostic laboratory price transparency
- 11- Beginning July 1, 2027, applicable laboratories must publicly disclose price information for specified lab tests, updated at least monthly if changes occur.
- 12- Information includes item descriptions and codes, gross charges, discounted cash prices or minimum cash prices for self-pay, payer-specific negotiated charges, and the range of negotiated charges.
- 13- Laboratories must publish data in a uniform format and include ancillary services associated with the test when applicable.
- 14- Penalties for noncompliance mirror the hospital provisions, with per-day fines and potential increases.
- 15Imaging transparency (imaging services)
- 16- Beginning July 1, 2027, imaging providers must publicly disclose prices for specified imaging services, in a format set by the Secretary, updated at least annually.
- 17- Information includes item descriptions and codes, gross charges, discounted cash prices or minimum cash prices for self-pay, payer-specific negotiated charges, and the range of negotiated charges.
- 18- Requires a uniform reporting format and enforcement similar to other sections.
- 19Ambulatory Surgical Center (ASC) transparency
- 20- Beginning July 1, 2027, specified ASCs must disclose standard charges for items and services, including shoppable services, in machine-readable and consumer-friendly formats.
- 21- Must include additional required charge information (e.g., payer-specific negotiated charges and ranges), with required protections around ancillary services bundled with a procedure.
- 22- Compliance monitoring and penalties align with the hospital and other price transparency provisions.
- 23General and operational details
- 24- The Act allows for civil penalties and potential increased penalties over time, with mechanisms for technical assistance and enforcement, and no authority to waive penalties.
- 25- State price-transparency laws are not superseded, except where they would block the Act’s requirements.
- 26- The Act emphasizes consumer access, prohibits relying on price-estimator tools as compliance, and directs the Secretary to run rulemaking to implement the details.