HR5378-118

Introduced

To promote price transparency in the health care sector, and for other purposes.

118th Congress Introduced Sep 8, 2023

Analysis under review: This bill has generated analysis that may be too generic or incomplete. Clause-level evidence remains available below.

Summary

What This Bill Does

This bill, To promote price transparency in the health care sector, and for other purposes., changes federal law or congressional policy affecting federal agencies and legislative administrators. The main policy domain is Government Operations, Healthcare, Finance.

Who Benefits and How

federal agencies and legislative administrators may benefit from new authority, funding, eligibility, regulatory clarity, or reduced risk created by the bill.

Who Bears the Burden and How

federal implementing agencies may take on implementation duties, reporting obligations, compliance costs, or oversight responsibilities.

Key Provisions

  • Section HBB513F8609A64365B3CF1F03C4F2BD26: 1. Short title This Act may be cited as the Lower Costs, More Transparency Act.
  • Section H2904B576190E426EA986D303C935DAE4: 2. Table of contents The table of contents of this Act is as follows:
  • Section H2B9674BFCA4C40398B3FEC043F9863F0: 101. Hospital price transparency Part E of title XVIII of the Social Security Act (42 U.S.C. 1395x et seq.) is amended by adding at the end the following new...
  • Section HFDCAE3C45C8540C1B9EB6A87998C0373: 1899C. Hospital price transparency Beginning January 1, 2026, each specified hospital that receives payment under this title for furnishing items and services...
  • Section HCDF7E4390B86408FA428CD48A1187ACA: 102. Clinical diagnostic laboratory test price transparency Section 1846 of the Social Security Act (42 U.S.C. 1395w–2) is amended— in the header, by inserting...

Evidence Chain:

This summary is generated from the full bill text using AI analysis. Expand "Detailed Analysis" below for identified beneficiaries/burden bearers with clause-level evidence links.

At a Glance

What This Bill Does

This bill, To promote price transparency in the health care sector, and for other purposes., changes federal law or congressional policy affecting federal agencies and legislative administrators.

Key Policy Areas

Government Operations, Healthcare, Finance

Primary Purpose

This bill, To promote price transparency in the health care sector, and for other purposes., changes federal law or congressional policy affecting federal agencies and legislative administrators.

Policy Domains

Government Operations Healthcare Finance

Whole bill

Identified Gains
  • federal agencies and legislative administrators
Model: codex-gpt-5 | Version: bill_summary_v2 | Source: eh
federal agencies and legislative administrators: , ,
Identified Costs
  • federal implementing agencies
Model: codex-gpt-5 | Version: bill_summary_v2 | Source: eh
federal implementing agencies: , ,

Legislative Progress

Introduced
Introduced Committee Passed
Sep 8, 2023

Mrs. Rodgers of Washington (for herself, Mr. Pallone, Mr. Smith …

Stakeholder Effects

cui bono?

How this legislation distributes effects. Mention counts reflect frequency, not effect magnitude.

Government
11 mentions across 11 clauses
+4 positive -7 negative

CMS provider enrollment, Department of Labor implementation staff, FDA

Positive-direction: Department of Labor implementation staff, HHS and Treasury implementation staff, Medicare program, National Health Service Corps

Negative-direction: CMS provider enrollment, FDA, Federal agencies (HHS, Labor, Treasury), Government Accountability Office, HHS and CMS, Medicaid Improvement Fund, Medicare Payment Advisory Commission

General Public
10 mentions across 10 clauses
+10 positive

ERISA plan participants and beneficiaries, Health insurance enrollees, Health plan beneficiaries

Healthcare
7 mentions across 7 clauses
-7 negative

Hospitals receiving Medicare payments, Off-campus hospital outpatient departments, Service providers to ERISA health plans

Pharmacy Benefit Management
7 mentions across 7 clauses
-7 negative

Pharmacy benefit managers, Pharmacy benefit managers in Medicaid, Pharmacy benefit managers providing services to health plans

Financial Services
7 mentions across 7 clauses
-7 negative

ERISA group health plans and health insurance issuers, Group health plans, Group health plans subject to IRC

Business
6 mentions across 6 clauses
+6 positive

ERISA plan fiduciaries and employers, ERISA plan sponsors, Employer plan sponsors

Manufacturing
3 mentions across 2 clauses
+1 positive -2 negative

Brand-name drug manufacturers, Drug manufacturers providing rebates, Generic drug manufacturers

Positive-direction: Generic drug manufacturers

Negative-direction: Brand-name drug manufacturers, Drug manufacturers providing rebates

Pharmacy
2 mentions across 2 clauses
+2 positive

Retail pharmacies, Retail pharmacies dispensing Medicaid prescriptions

29/36
sections analyzed
Full impact breakdown

Bill Structure & Actor Mappings

Who is "The Secretary" in each section?

Domains
Government Operations Healthcare Finance
Actor Mappings
"the_commission"
→ The commission identified in the operative section
"the_administrator"
→ The Administrator identified in the operative section
"secretary_of_labor"
→ Secretary of Labor
"secretary_of_treasury"
→ Secretary of the Treasury
"secretary_of_health_and_human_services"
→ Secretary of Health and Human Services

Key Definitions

Terms defined in this bill

5 terms
"specified OPD services" §H06404638F44043A190D2B30D9FA82223

covered OPD services assigned to a designated ambulatory payment classification group. Section 1833(t)(12) of the Social Security Act (42 U.S.C. 1395l(t)(12)) is amended— in subparagraph (D), by striking and at the end

"gross charge" §H2B9674BFCA4C40398B3FEC043F9863F0

the charge for an individual item or service that is reflected on a specified hospital’s or provider of service’s or supplier’s, as applicable, chargemaster, absent any discounts. (4)Group health plan

"gross charge" §H44612F46DB58436EB001A8FA31F45FC9

the charge for an individual item or service that is reflected on an ambulatory surgical center’s chargemaster, absent any discounts. (D)Group health plan

"designated entity" §HCC954800F0A94AF6BD497AD3DF767E59

a managed care entity or other specified entity. (ii)Managed care entity

"off-campus outpatient department of a provider" §HDCE2385287134C5A89FAC8DE28C7DBD5

a department of a provider (as defined in section 413.65 of title 42, Code of Federal Regulations, or any successor regulation) that is not located— on the campus (as defined in such section) of such provider

We use a combination of our own taxonomy and classification in addition to large language models to assess meaning and potential beneficiaries. High confidence means strong textual evidence. Always verify with the original bill text.

Learn more about our methodology