The Health ACCESS Act would modify the current anti-kickback safe harbor in the Social Security Act to explicitly allow, under tightly controlled conditions, remuneration paid by providers or suppliers to information service providers (ISPs) that operate web-based platforms used by consumers to search for health care providers or suppliers. The goal is to lower barriers to care and speed up patient access by enabling these platforms to offer financing arrangements (remuneration) that align with fair market value and transparency, while preventing patient steering, misleading claims, or targeted marketing. The bill defines key terms and sets a detailed set of safeguards the ISPs must meet to qualify for the safe harbor. Introduced in the Senate by Senators Cassidy and Padilla, the act would add a new safe-harbor provision (within 1128B(b)(3)(M)) that lays out conditions for when an information service provider can receive payments from providers or suppliers without triggering penalties under the anti-kickback statute. It emphasizes consumer protection, transparency, objective criteria for participation, and Secretary-approved standards.
Key Points
- 1Creates a new safe harbor for remuneration to information service providers (ISPs) that run web platforms used by consumers to search for health care providers or suppliers.
- 2Prohibits ISPs from activities that could bias consumer choice, including:
- 3- Steering or leading consumers to a provider based on payment arrangements.
- 4- Making promises of cures or health guarantees.
- 5- Sharing consumer contact information with providers except the one chosen by the consumer.
- 6- Arranging transportation to/from a provider.
- 7- Providing or arranging other improper remuneration to federal health care program beneficiaries beyond inherent convenience.
- 8- Targeted marketing to consumers who have not interacted or who have opted out.
- 9Requires advance, written, fair-market-value-based compensation terms for services provided by the ISP; compensation cannot rely on or reflect items/services payable by federal health care programs resulting from provider recommendations.
- 10Mandates disclosure: ISPs must clearly disclose their financial arrangements to consumers.
- 11Demands objective, consumer-centric information and participation criteria:
- 12- Information provided to consumers must be based on objective criteria.
- 13- Participation criteria must be objective and non-discriminatory; qualified providers/suppliers should not be excluded without justification.
- 14- The ISP must meet additional conditions as determined by the Secretary of Health and Human Services.
- 15Definitions added:
- 16- Consumer: an individual using a web-based platform to search for providers or suppliers.
- 17- Information service provider: any entity operating a web-based platform that makes provider/supplier information available to consumers.
- 18The bill preserves the broader safe harbor framework for information services within Section 1128B but adds these new guardrails to ensure consumer protection and fair dealing.
- 19The act’s overall aim is to accelerate access to care by enabling self-scheduling and quicker connections to providers, while maintaining safeguards against improper influence or marketing.