Tuesday, May 21, 2024

House lawmakers unveil bipartisan legislation tackling health care cost and price transparency



House members from three key committees introduced a bipartisan health care bill Friday aimed at addressing price transparency, prescription drug costs and workforce investment, consolidating measures that already have been advanced by the respective panels.

Leadership from the House Energy and Commerce, Ways and Means and Education and the Workforce committees introduced the Lower Costs, More Transparency Act, tying together numerous pieces of legislation focused on improving health care affordability.

“Our bipartisan legislation meets this moment by giving patients what they are rightfully demanding: the ability to get the right care, at the right time, at a price they know and can afford,” said Rep. Cathy McMorris Rodgers (R-Wash.), chairwoman of the Energy and Commerce Committee, in a statement.

“It will lower costs by giving patients the health care price information they need to make the decisions that are best for them and their families — something 95 percent of Americans support.”

The legislation includes provisions from the PATIENT Act introduced in May that would require hospitals to publicize the standard prices for all items and services in a readable format. The bill would also require upfront transparency on the cost of imaging services and laboratory testing, as well as require pharmacy benefit managers (PBM) to provide employers with spending data.

Going further on PBMs, the bill includes measures that would ban the practice of spread pricing in Medicaid. Spread pricing refers to when PBMs charge insurance providers more for medication than what they pay the pharmacy, keeping the resulting “spread.” PBMs who contract with Managed Care Organizations would be barred from spread pricing.

“This bill represents what our committees do at their best: work together to deliver bipartisan results for the American people. I’m grateful to my colleagues for partnering with me to strengthen the bill,” Energy and Commerce Committee ranking member Rep. Frank Pallone (D-N.J.) said.

Outside of price transparency, the package extends investments into the Community Health Center Fund, the National Health Service Corps and the Special Diabetes Program for research as well as health workforce training programs.

At the same time, the bill proposes cutting $7 billion from the Medicaid Improvement Fund — which specifically seeks to improve the parts of Medicaid that provide hospital and medical insurance — as well as $8 billion for the next two years from Medicaid Disproportionate Share Hospital payments going to hospitals that serve large portions of those who are on Medicaid or uninsured.

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