Mr. Armstrong

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6. Strengthening health coverage transparency requirements Section 2715A of the Public Health Service Act (42 U.S.C. 300gg-15a) is amended— by striking A Group health and inserting the following: (a)In generalA group health; and A group health by ending at the end the following: (b)Additional transparency requirements(1)Specified information required(A)In generalA group health plan or health insu…

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8. Oversight of administrative service providers Part D of title XXVII of the Public Health Service Act (42 U.S.C. 300gg–111 et seq.), as amended by section 6701(a) of the Consolidated Appropriations Act, 2026, is amended by adding at the end the following: 2799A–12.Oversight of administrative service providers(a)In generalFor plan years beginning on or after January 1 of the year that begins on …

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7. Increasing group health plan access to health data Section 2799A-9 of the Public Health Service Act (42 U.S.C. 300gg-119) is amended by adding at the end the following: (1)Group Health Plan Access to Information(A)In generalNo contract or arrangement for services, and no extension or renewal of such contract or arrangement, between a group health plan that is offered by a specified large emplo…

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2799A–12. Oversight of administrative service providers For plan years beginning on or after January 1 of the year that begins on or after the date that is 1 year after the date of enactment of the Patients Deserve Price Tags Act, no agreement between a group health plan that is offered by a specified large employer or that is a specified large plan (as such terms are defined in section 2799A–11(…

This clause introduces a compliance mandate and a reporting or study requirement: Prohibits ERISA group health plan service provider agreements that limit disclosure of pricing and claims information, requiring quarterly disclosure of methodologies, rebates, and fees. It is likely beneficial for Self-insured employers and plan sponsors (cost down). It likely creates costs, burdens, barriers, or risks for Pharmacy benefit managers (compliance burden up) and Third-party administrators (compliance burden up).

This clause introduces a compliance mandate and a reporting or study requirement: Extends administrative service provider oversight requirements to self-funded non-Federal governmental health plans, requiring quarterly disclosure of pricing and rebate information. It is likely beneficial for State and local government health plan sponsors (cost down). It likely creates costs, burdens, barriers, or risks for Health plan service providers serving governmental plans (compliance burden up) and Pharmacy benefit managers serving governmental plans (compliance burden up).

This clause introduces a compliance mandate and a reporting or study requirement: Codifies Section 726 oversight requirements for ERISA administrative service providers including disclosure of pricing formulas and rebate information to health plans. It is likely beneficial for Group health plan sponsors (cost down). It likely creates costs, burdens, barriers, or risks for Health plan service providers and TPAs (compliance burden up) and Pharmacy benefit managers (compliance burden up).

This clause introduces a compliance mandate and a reporting or study requirement: Requires group health plan service contracts to provide plan fiduciaries access to all claims data, pricing methodologies, and prohibits contracts that restrict such access. It is likely beneficial for Self-insured employer health plan sponsors (revenue opp up). It likely creates costs, burdens, barriers, or risks for Pharmacy benefit managers (compliance burden up), Third-party administrators (compliance burden up), and Healthcare provider networks (compliance burden up).

This clause tightens a reporting or study requirement and a compliance mandate: Strengthens health plan transparency requirements by mandating disclosure of in-network rates, maximum allowed amounts for out-of-network, and patient cost-sharing through self-service tools. It is likely beneficial for Individual health insurance consumers (cost down). It likely creates costs, burdens, barriers, or risks for Health insurance exchanges and qualified health plans (compliance burden up).