Patients Deserve Price Tags Act
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 requires hospitals, labs, imaging centers, and surgical centers to publicly post their prices online in formats that consumers can easily understand and compare. It also requires health insurance plans to provide detailed cost estimates before and after receiving care.
Who Benefits and How
Patients and healthcare consumers benefit by gaining access to actual prices before receiving care, enabling them to shop for lower-cost options. Self-insured employer health plans gain access to detailed claims data and pricing information from their service providers, allowing them to better manage healthcare costs.
Who Bears the Burden and How
Hospitals must compile and publish monthly pricing data for all services including negotiated rates with insurers. Clinical labs and imaging providers must publish pricing by July 2027. Pharmacy benefit managers and third-party administrators must disclose their pricing methodologies, rebates, and fees to health plans quarterly.
Key Provisions
- Hospitals must publish machine-readable files with standard charges, negotiated rates, and cash prices monthly
- Labs and imaging centers must publish pricing by July 2027
- Health plans must provide advance cost estimates showing in-network rates and patient cost-sharing
- PBMs and TPAs must disclose all rebates, fees, and pricing formulas to employer health plans
Evidence Chain:
This summary is generated from the full bill text using AI analysis. Expand "Detailed Analysis" below for identified beneficiaries/burden bearers.
At a Glance
What This Bill Does
Mandates comprehensive healthcare price transparency by requiring hospitals, labs, imaging centers, ambulatory surgical centers, and health plans to publicly disclose pricing information in standardized, consumer-friendly formats
Key Policy Areas
Healthcare, Consumer Protection, Health Insurance
Primary Purpose
Mandates comprehensive healthcare price transparency by requiring hospitals, labs, imaging centers, ambulatory surgical centers, and health plans to publicly disclose pricing information in standardized, consumer-friendly formats
Policy Domains
Billing and Explanation of Benefits
Identified Gains
Contextual inference, no direct clause citation- Patients
- Healthcare consumers
Contextual inference, no direct clause citation
Identified Costs
Contextual inference, no direct clause citation- Healthcare providers
- Healthcare facilities
- Health insurers
Contextual inference, no direct clause citation
Hospital Price Transparency
Identified Gains
Contextual inference, no direct clause citation- Healthcare consumers
- Self-pay patients
- Health plan sponsors
Contextual inference, no direct clause citation
Identified Costs
Contextual inference, no direct clause citation- Hospitals
- Hospital systems
Contextual inference, no direct clause citation
Health Plan and Insurance Transparency
Identified Gains
Contextual inference, no direct clause citation- Employer health plan sponsors
- Plan fiduciaries
- Self-insured employers
Contextual inference, no direct clause citation
Identified Costs
Contextual inference, no direct clause citation- Pharmacy benefit managers
- Third-party administrators
- Healthcare networks
Contextual inference, no direct clause citation
Lab, Imaging, and ASC Transparency
Identified Gains
Contextual inference, no direct clause citation- Healthcare consumers
- Self-pay patients
Contextual inference, no direct clause citation
Identified Costs
Contextual inference, no direct clause citation- Clinical laboratories
- Imaging centers
- Ambulatory surgical centers
Contextual inference, no direct clause citation
Sponsors
Legislative Progress
In CommitteeCommittee on Health, Education, Labor, and Pensions. Hearings held.
Mr. Marshall (for himself, Mr. Hickenlooper, Mr. Grassley, Ms. Hassan, …
Read twice and referred to the Committee on Health, Education, …
Introduced in Senate
Stakeholder Effects
cui bono?How this legislation distributes effects. Mention counts reflect frequency, not effect magnitude.
Health plan participants and enrollees, Healthcare consumers and patients, Healthcare consumers needing imaging services
Healthcare facilities, Healthcare facilities in states with stronger requirements, Healthcare facilities including hospitals
Group health plans and health insurers, Health insurance exchanges and qualified health plans, Health plan service providers serving governmental plans
Pharmacy benefit managers, Pharmacy benefit managers serving governmental plans
Group health plan sponsors, Self-insured employer health plan sponsors, Self-insured employers and plan sponsors
Healthcare providers and facilities, Healthcare providers including telehealth providers
Clinical diagnostic laboratories
Freestanding imaging centers and radiology providers
Bill Structure & Actor Mappings
Who is "The Secretary" in each section?
- "the_secretary"
- → Secretary of Health and Human Services
- "the_secretary"
- → Secretary of Health and Human Services
- "the_secretary"
- → Secretary of Labor
- "the_secretary"
- → Secretary of Health and Human Services
Note: The Secretary refers to HHS Secretary for healthcare facility provisions but Secretary of Labor for ERISA group health plan provisions
Key Definitions
Terms defined in this bill
Includes gross charge, discounted cash price, payer-specific negotiated charges, and de-identified minimum and maximum negotiated charges for each item or service
A laboratory that furnishes specified clinical diagnostic laboratory tests
An ambulatory surgical center that furnishes specified surgical services
Health care providers, networks or associations of providers, service providers offering access to networks, third-party administrators, or pharmacy benefit managers
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