Vote Smart's Synopsis:

Vote to pass a bill requires health care providers and insurers disclose certain information about health care costs.

Highlights:

• Requires health care providers and insurers disclose certain information about health care costs and establishes requirements for certain payment methodolgies under Medicare and Medicaid and extends several public health programs (Title I, Sec. 101-105).

• Authorizes regulations that require hospitals to annually publish their prices and related information, including the discounted cash price and negotiate charges and extends these regulations to the following, including (Title II, Sec. 106-111):

• Clinical laboratories;

• Imaging service providers; and

• Ambulatory surgical centers that participate in Medicare.

• Requires pharmacy benefit managers (PBMs) to semiannualy report to health plan sponsors on the number and typs of claims for covered drugs, including whether the drugs were brand-name or generic drugs and associated costs (Title II, Sec. 201-202).

• Requires contracts with PBMs for employer-sponsored health plans to allow health plan fudiciares to audit certain claims and costs information without undue restrictions (Title II, Sec. 203-204).

• Requires pass-through pricing models, and prohibits spread-pricing for payment arrangements with PBMs under medicaid (Title III, Sec. 301-302).

• Requires Medicare payments for certain drug adminstration services at off-campus hospital outpatient departments to be the same as that for other provider settings such as physican offices (Title III, Sec. 303-304).

• Appropriates funding for the Department of Health and Human Services, the Department of Treasury, and the Department of Labor to implement and enforce this bill’s requirements (Title IV, Sec. 401-402).

• Extends several federal public health programs, including (Title IV, Sec. 403-404):

• The Teaching Center Graduate Medical Education Program through fiscal year 2030; and

• The National Health Service Corps.

Full Bill Text

Full Bill Text