Health Care Price Transparency Promotion Act of 2006 - Amends title XIX (Medicaid) of the Social Security Act to require state Medicaid plans to provide that the state will establish and maintain laws to require disclosure of information on hospital charges, to make such information available to the public, and to provide individuals with information about estimated out-of-pocket costs for health care services.
Directs the Director of the Agency for Healthcare Research and Quality to research and report to Congress on: (1) the types of information on the charges and out-of-pocket costs for health care services that individuals find useful in making decisions about where, when, and from whom to receive care; (2) how such types of information vary by whether they have health benefits coverage, and what kinds; and (3) ways in which such information may be available on a timely basis and in easy-to-understand form to individuals facing such decisions.
[Congressional Bills 109th Congress]
[From the U.S. Government Publishing Office]
[H.R. 6053 Introduced in House (IH)]
109th CONGRESS
2d Session
H. R. 6053
To amend title XIX of the Social Security Act to provide for increased
price transparency of hospital information and to provide for
additional research on consumer information on charges and out-of-
pocket costs.
_______________________________________________________________________
IN THE HOUSE OF REPRESENTATIVES
September 12, 2006
Mr. Burgess introduced the following bill; which was referred to the
Committee on Energy and Commerce
_______________________________________________________________________
A BILL
To amend title XIX of the Social Security Act to provide for increased
price transparency of hospital information and to provide for
additional research on consumer information on charges and out-of-
pocket costs.
Be it enacted by the Senate and House of Representatives of the
United States of America in Congress assembled,
SECTION 1. SHORT TITLE.
This Act may be cited as the ``Health Care Price Transparency
Promotion Act of 2006''.
SEC. 2. INCREASING THE TRANSPARENCY OF INFORMATION ON HOSPITAL CHARGES
AND MAKING AVAILABLE INFORMATION ON ESTIMATED OUT-OF-
POCKET COSTS FOR HEALTH CARE SERVICES.
(a) In General.--Section 1902(a) of the Social Security Act (42
U.S.C. 1396a(a)) is amended--
(1) by striking ``and'' at the end of paragraph (69);
(2) by striking the period at the end of paragraph (70) and
inserting ``; and'';
(3) by inserting after paragraph (70) the following new
paragraph:
``(71) provide that the State will establish and maintain
laws, in accordance with the requirements of section 1921A, to
require disclosure of information on hospital charges, to make
such information available to the public, and to provide
individuals with information about estimated out-of-pocket
costs for health care services.''; and
(4) by inserting after section 1921 the following new
section:
``increasing the transparency of information on hospital charges and
providing consumers with estimates of out-of-pocket costs for health
care services
``Sec. 1921A. (a) In General.--The requirements referred to in
section 1902(a)(71) are that the laws of a State must--
``(1) in accordance with subsection (b)--
``(A) require the disclosure of information on
hospital charges; and
``(B) provide for access to such information; and
``(2) in accordance with subsection (c), require the
provision of a statement of the estimated out-of-pocket costs
of an individual for anticipated future health care services.
``(b) Information on Hospital Charges.--The laws of a State must--
``(1) require disclosure, by each hospital located in the
State, of information on the charges for certain inpatient and
outpatient hospital services (as determined by the State)
provided at the hospital; and
``(2) provide for timely access to such information by
individuals seeking or requiring such services.
``(c) Estimated Out-of-Pocket Costs.--The laws of a State must
require that, upon the request of any individual with health insurance
coverage sponsored by a health insurance issuer, the issuer must
provide a statement of the estimated out-of-pocket costs that are
likely to be incurred by the individual if the individual receives
particular health care items and services within a specified period of
time.
``(d) Rules of Construction.--Nothing in this section shall be
construed as--
``(1) authorizing or requiring the Secretary to establish
uniform standards for the State laws required by subsections
(b) and (c);
``(2) requiring any State with a law enacted on or before
the date of the enactment of this section that--
``(A) meets the requirements of subsection (b) or
subsection (c) to modify or amend such law; or
``(B) meets some but not all of the requirements of
subsection (b) or subsection (c) to modify or amend
such law except to the extent necessary to address the
unmet requirements;
``(3) precluding any State in which a program of voluntary
disclosure of information on hospital charges is in effect from
adopting a law codifying such program (other than its voluntary
nature) to satisfy the requirement of subsection (b)(1); or
``(4) guaranteeing that the out-of-pocket costs of an
individual will not exceed the estimate of such costs provided
pursuant to subsection (c).
``(e) Definitions.--For purposes of this section:
``(1) The term `health insurance coverage' has the meaning
given such term in section 2791(b)(1) of the Public Health
Service Act.
``(2) The term `health insurance issuer' has the meaning
given such term in section 2791(b)(2) of the Public Health
Service Act, except that such term also includes--
``(A) a medicaid managed care organization (as
defined in section 1903(m)); and
``(B) a Medicare Advantage organization (as defined
in 1859(a)(1), taking into account the operation of
section 201(b) of the Medicare Prescription Drug,
Improvement, and Modernization Act of 2003).
Section 1856(b)(3) shall not preclude the application to a
Medicare Advantage organization or a Medicare Advantage plan
offered by such an organization of any State law adopted to
carry out the requirements of subsection (b) or (c).
``(3) The term `hospital' means an institution that meets
the requirements of paragraphs (1) and (7) of section 1861(e)
and includes those to which section 1820(c) applies.''.
(b) Effective Date.--
(1) In general.--Except as provided in paragraph (2), the
amendments made by subsection (a) shall take effect on October
1, 2007.
(2) Exception.--In the case of a State plan for medical
assistance under title XIX of the Social Security Act which the
Secretary of Health and Human Services determines requires
State legislation (other than legislation appropriating funds)
in order for the plan to meet the additional requirements
imposed by the amendment made by subsection (a), the State plan
shall not be regarded as failing to comply with the
requirements of such title solely on the basis of its failure
to meet these additional requirements before the first day of
the first calendar quarter beginning after the close of the
first regular session of the State legislature that begins
after the date of the enactment of this Act. For purposes of
the previous sentence, in the case of a State that has a 2-year
legislative session, each year of such session shall be deemed
to be a separate regular session of the State legislature.
SEC. 3. RESEARCH ON INFORMATION VALUED BY CONSUMERS ON CHARGES AND OUT-
OF-POCKET COSTS FOR HEALTH CARE SERVICES.
(a) Research on Information Valued and Used by Consumers.--The
Director of the Agency for Healthcare Research and Quality (in this
section referred to as ``AHRQ'') shall conduct or support research,
pursuant to section 901(b)(1)(D) of the Public Health Service Act (42
U.S.C. 299(b)(1)(D)), on--
(1) the types of information on the charges, and out-of-
pocket costs, for health care services that individuals find
useful in making decisions about where, when, and from whom to
receive care;
(2) how the types of information valued by individuals for
making such decisions vary by whether they have health benefits
coverage and, if they do, the type of such coverage they have,
such as traditional insurance, health maintenance
organizations, preferred provider organizations, and high
deductible plans coupled with health savings accounts; and
(3) ways in which such information may be made available on
a timely basis and in easy-to-understand form to individuals
facing such decisions.
(b) Report.--The Director of AHRQ shall report to the Congress on
the results of such research not later than 18 months after the date of
the enactment of this Act, together with recommendations for ways in
which the Federal Government can assist the States in achieving the
objective specified in subsection (a)(3).
(c) Authorization of Appropriations.--There are authorized to be
appropriated such sums as may be necessary to carry out this section.
<all>
Introduced in House
Introduced in House
Sponsor introductory remarks on measure. (CR H6398, CR E1698)
Referred to the House Committee on Energy and Commerce.
Referred to the Subcommittee on Health.
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