What does Preamble of Lower Costs, More Transparency Act of 2026 do?

This bill is formally titled 'To promote price transparency in the health care sector'.

What does SHORT TITLE. of Lower Costs, More Transparency Act of 2026 do?

This bill is formally titled the Lower Costs, More Transparency Act of 2026

What does HOSPITAL PRICE TRANSPARENCY. of Lower Costs, More Transparency Act of 2026 do?

This section amends title XVIII of the Social Security Act to add section 1899D, establishing a hospital price transparency requirement. Beginning January 1, 2028, specified hospitals receiving Medicare payments must comply with this requirement. Hospitals must publicly disclose standard charges and prices in a method and format established by the Secretary. The required disclosures include all standard charges, consumer-friendly pricing for shoppable services, national provider identifiers, and an attestation of accuracy. Hospitals must also disclose information such as gross charges, discounted cash prices (or median cash prices if unavailable), payer-specific negotiated charges, and de-identified maximum and minimum negotiated charges. The Secretary will establish a standard, uniform method and format for hospitals to use and will monitor compliance. Failure to comply can result in notifications, requests for corrective action plans, and civil monetary penalties. The Secretary will make information about hospital compliance and enforcement activities publicly available.

What does CLINICAL DIAGNOSTIC LABORATORY TEST PRICE TRANSPARENCY. of Lower Costs, More Transparency Act of 2026 do?

This section amends Section 1846 of the Social Security Act to add a price transparency requirement for clinical diagnostic laboratory tests. Beginning January 1, 2028, applicable laboratories receiving payment under the title must publicly disclose discounted cash prices (or gross charges if no discounted price exists) for specified clinical diagnostic laboratory tests on an internet website. The Secretary will establish a standard method and format for laboratories to use in compiling and making public this information, no later than January 1, 2028. The price disclosures must include charges for ancillary services normally furnished with the test. If a laboratory fails to comply, the Secretary may impose a civil monetary penalty, initially not exceeding $300 per day. The Secretary may increase the per-day penalty limit through rulemaking, starting in 2029. The Secretary is required to provide technical assistance to laboratories requesting it. ’Applicable laboratory’ is defined based on 42 C.F.R. § 414.502, excluding laboratories that already make standard charges available through hospitals or ambulatory surgical centers. ’Discounted cash price’ refers to the charge for individuals paying cash, and ‘gross charge’ is the charge listed on the laboratory's chargemaster.

What does IMAGING PRICE TRANSPARENCY. of Lower Costs, More Transparency Act of 2026 do?

This section amends the Social Security Act to add price transparency for imaging services. Providers and suppliers must make publicly available the discounted cash price for each imaging service on an internet website. The information must be updated at least annually and include an attestation of completeness and accuracy. The Secretary shall establish a standard method and format for making this information public. The Secretary will monitor compliance and may impose a civil monetary penalty for non-compliance.

What does AMBULATORY SURGICAL CENTER PRICE TRANSPARENCY. of Lower Costs, More Transparency Act of 2026 do?

This section amends the Social Security Act to establish price transparency requirements for ambulatory surgical centers (ASCs) receiving payment under the title. Beginning January 1, 2028, ASCs must compile and make public their standard charges and prices in a method and format established by the Secretary. The required public information includes standard charges, gross charges, discounted cash prices (or median cash prices if no discounted cash price is available), and descriptions of items and services. ASCs must also publish prices for at least 300 shoppable services, or all additional services if they furnish fewer than 300. The Secretary will establish a standard, uniform method and format for ASCs to use, updated as appropriate in consultation with stakeholders. The Secretary will monitor and assess ASC compliance through evaluations, analyses of complaints, audits, and obtaining additional information. ASCs failing to comply may receive notification from the Secretary and be required to submit a corrective action plan. Civil monetary penalties may be imposed for non-compliance, with the Secretary having the authority to increase penalty amounts and waive or reduce penalties in certain circumstances, such as for ASCs in rural or underserved areas. The Secretary is required to provide technical assistance to ASCs requesting it.

What does HEALTH COVERAGE PRICE TRANSPARENCY. of Lower Costs, More Transparency Act of 2026 do?

This section amends the Internal Revenue Code of 1986 to require transparency in health coverage prices. Group health plans must provide information on cost-sharing, including deductibles, copayments, and coinsurance, for specific items or services. Plans must also make available to the public the rate and payment information for items and services, including in-network rates and average amounts paid. The section defines key terms, such as 'applicable spread price drug', 'in-network rate', and 'participating provider'. Pharmacy benefit management services must disclose information on applicable spread price drugs and payment amounts.

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Lower Costs, More Transparency Act of 2026

Last updated: 6/25/2026 · Introduced: 6/23/2026

Author: Brett Guthrie (R-KY)

TL;DR (AI)

Hospitals receiving Medicare payments must publicly disclose standard charges, consumer-friendly pricing, and payer-specific negotiated charges, starting January 1, 2028.
Clinical diagnostic laboratories receiving Medicare payments must publicly disclose discounted cash prices (or gross charges) for specified tests, also beginning January 1, 2028.
Providers and suppliers of imaging services must make discounted cash prices for each service publicly available on an internet website, updated at least annually.
Ambulatory surgical centers (ASCs) receiving Medicare payments must publicly disclose standard charges, gross charges, and discounted cash prices, and publish prices for at least 300 shoppable services, starting January 1, 2028.
Group health plans must provide information on cost-sharing and make available rate and payment information for items and services, including in-network rates, to both plan members and the public.

119th Congressin committeeOfficial page

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Other Sections

Includes provisions on preamble, short title., and 5 more.

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