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Lower Costs, More Transparency Act

USA118th CongressHR-5378| House 
| Updated: 12/12/2023
Cathy McMorris Rodgers

Cathy McMorris Rodgers

Republican Representative

Washington

Cosponsors (3)
Jason Smith (Republican)Virginia Foxx (Republican)Frank Pallone (Democratic)

Ways and Means Committee, Health Subcommittee, Energy and Commerce Committee, Education and Workforce Committee

  • Introduced
  • In Committee
  • On Floor
  • Passed Chamber
  • Enacted
Lower Costs, More Transparency Act This bill requires health care providers and insurers to disclose certain information about health care costs. It also establishes requirements for certain payment methodologies under Medicare and Medicaid and extends several public health programs. For example, the bill provides statutory authority for regulations that require hospitals to annually publish their prices and related information, including the discounted cash price and negotiated charges. The bill also specifically extends these requirements to clinical laboratories, imaging service providers, and ambulatory surgical centers that participate in Medicare. Additionally, pharmacy benefit managers (PBMs) must semiannually report to health plan sponsors certain information on spending, rebates, and fees that are associated with covered drugs. Contracts with PBMs for employer-sponsored health plans must also allow health plan fiduciaries to audit certain claims and cost information without undue restrictions. In addition, the bill requires pass-through pricing models, and prohibits spread-pricing, for payment arrangements with PBMs under Medicaid. It also requires Medicare payments for certain drug administration services at off-campus hospital outpatient departments to be the same as that for other provider settings (i.e., physician offices). The bill provides funds for the Department of Health and Human Services, the Department of Treasury, and the Department of Labor to implement and enforce the bill's requirements. Finally, the bill extends several public health programs, including the Teaching Health Center Graduate Medical Education Program (through FY2030) and the National Health Service Corps (through December 31, 2025).

Bill Text Versions

View Text
2 versions available

Suggested Questions

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Timeline
Sep 8, 2023
Introduced in House
Sep 8, 2023
Referred to the Committee on Energy and Commerce, and in addition to the Committees on Ways and Means, and Education and the Workforce, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.
Sep 15, 2023
Referred to the Subcommittee on Health.
Dec 11, 2023
Mrs. Rodgers (WA) moved to suspend the rules and pass the bill, as amended.
Dec 11, 2023
Considered under suspension of the rules. (consideration: CR H6762-6789)
Dec 11, 2023
DEBATE - The House proceeded with forty minutes of debate on H.R. 5378.
Dec 11, 2023
At the conclusion of debate, the Yeas and Nays were demanded and ordered. Pursuant to the provisions of clause 8, rule XX, the Chair announced that further proceedings on the motion would be postponed.
Dec 12, 2023
Considered as unfinished business. (consideration: CR H6801-6802)
Dec 12, 2023
On motion to suspend the rules and pass the bill, as amended Agreed to by the Yeas and Nays: (2/3 required): 320 - 71, 1 Present (Roll no. 708). (text: CR H6762-6785)
View Vote
Dec 12, 2023
Motion to reconsider laid on the table Agreed to without objection.
  • September 8, 2023
    Introduced in House


  • September 8, 2023
    Referred to the Committee on Energy and Commerce, and in addition to the Committees on Ways and Means, and Education and the Workforce, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.


  • September 15, 2023
    Referred to the Subcommittee on Health.


  • December 11, 2023
    Mrs. Rodgers (WA) moved to suspend the rules and pass the bill, as amended.


  • December 11, 2023
    Considered under suspension of the rules. (consideration: CR H6762-6789)


  • December 11, 2023
    DEBATE - The House proceeded with forty minutes of debate on H.R. 5378.


  • December 11, 2023
    At the conclusion of debate, the Yeas and Nays were demanded and ordered. Pursuant to the provisions of clause 8, rule XX, the Chair announced that further proceedings on the motion would be postponed.


  • December 12, 2023
    Considered as unfinished business. (consideration: CR H6801-6802)


  • December 12, 2023
    On motion to suspend the rules and pass the bill, as amended Agreed to by the Yeas and Nays: (2/3 required): 320 - 71, 1 Present (Roll no. 708). (text: CR H6762-6785)
    View Vote


  • December 12, 2023
    Motion to reconsider laid on the table Agreed to without objection.

Health

Related Bills

  • S 118-2308: Community Health Care Reauthorization Act
  • HR 118-4883: Medicare Common Ownership Transparency Act of 2023
  • HR 118-3284: Providers and Payers COMPETE Act
  • S 118-775: Increasing Transparency in Generic Drug Applications Act
  • HR 118-3237: To amend title XVIII of the Social Security Act to require each off-campus outpatient department of a provider to include a unique identifier on claims for items and services, and to require providers with a department of a provider to submit to the Centers for Medicare & Medicaid Services an attestation with respect to each such department.
  • HR 118-3839: To amend the Federal Food, Drug, and Cosmetic Act to increase transparency in generic drug applications.
  • HR 118-4508: Hidden Fee Disclosure Act of 2023
  • S 118-1855: Special Diabetes Program Reauthorization Act of 2023
  • HR 118-2665: Supporting Safety Net Hospitals Act
  • HR 118-4527: Health DATA Act of 2023
Administrative law and regulatory proceduresAdvisory bodiesCivil actions and liabilityComputers and information technologyCongressional oversightConsumer affairsDepartment of Health and Human ServicesDigestive and metabolic diseasesGovernment information and archivesHealth care costs and insuranceHealth care coverage and accessHealth facilities and institutionsHealth personnelHome and outpatient careHospital careMedicaidMedicarePhotography and imagingPrescription drugsState and local government operationsSurgery and anesthesia

Lower Costs, More Transparency Act

USA118th CongressHR-5378| House 
| Updated: 12/12/2023
Lower Costs, More Transparency Act This bill requires health care providers and insurers to disclose certain information about health care costs. It also establishes requirements for certain payment methodologies under Medicare and Medicaid and extends several public health programs. For example, the bill provides statutory authority for regulations that require hospitals to annually publish their prices and related information, including the discounted cash price and negotiated charges. The bill also specifically extends these requirements to clinical laboratories, imaging service providers, and ambulatory surgical centers that participate in Medicare. Additionally, pharmacy benefit managers (PBMs) must semiannually report to health plan sponsors certain information on spending, rebates, and fees that are associated with covered drugs. Contracts with PBMs for employer-sponsored health plans must also allow health plan fiduciaries to audit certain claims and cost information without undue restrictions. In addition, the bill requires pass-through pricing models, and prohibits spread-pricing, for payment arrangements with PBMs under Medicaid. It also requires Medicare payments for certain drug administration services at off-campus hospital outpatient departments to be the same as that for other provider settings (i.e., physician offices). The bill provides funds for the Department of Health and Human Services, the Department of Treasury, and the Department of Labor to implement and enforce the bill's requirements. Finally, the bill extends several public health programs, including the Teaching Health Center Graduate Medical Education Program (through FY2030) and the National Health Service Corps (through December 31, 2025).

Bill Text Versions

View Text
2 versions available

Suggested Questions

Get AI-generated questions to help you understand this bill better

Timeline
Sep 8, 2023
Introduced in House
Sep 8, 2023
Referred to the Committee on Energy and Commerce, and in addition to the Committees on Ways and Means, and Education and the Workforce, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.
Sep 15, 2023
Referred to the Subcommittee on Health.
Dec 11, 2023
Mrs. Rodgers (WA) moved to suspend the rules and pass the bill, as amended.
Dec 11, 2023
Considered under suspension of the rules. (consideration: CR H6762-6789)
Dec 11, 2023
DEBATE - The House proceeded with forty minutes of debate on H.R. 5378.
Dec 11, 2023
At the conclusion of debate, the Yeas and Nays were demanded and ordered. Pursuant to the provisions of clause 8, rule XX, the Chair announced that further proceedings on the motion would be postponed.
Dec 12, 2023
Considered as unfinished business. (consideration: CR H6801-6802)
Dec 12, 2023
On motion to suspend the rules and pass the bill, as amended Agreed to by the Yeas and Nays: (2/3 required): 320 - 71, 1 Present (Roll no. 708). (text: CR H6762-6785)
View Vote
Dec 12, 2023
Motion to reconsider laid on the table Agreed to without objection.
  • September 8, 2023
    Introduced in House


  • September 8, 2023
    Referred to the Committee on Energy and Commerce, and in addition to the Committees on Ways and Means, and Education and the Workforce, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.


  • September 15, 2023
    Referred to the Subcommittee on Health.


  • December 11, 2023
    Mrs. Rodgers (WA) moved to suspend the rules and pass the bill, as amended.


  • December 11, 2023
    Considered under suspension of the rules. (consideration: CR H6762-6789)


  • December 11, 2023
    DEBATE - The House proceeded with forty minutes of debate on H.R. 5378.


  • December 11, 2023
    At the conclusion of debate, the Yeas and Nays were demanded and ordered. Pursuant to the provisions of clause 8, rule XX, the Chair announced that further proceedings on the motion would be postponed.


  • December 12, 2023
    Considered as unfinished business. (consideration: CR H6801-6802)


  • December 12, 2023
    On motion to suspend the rules and pass the bill, as amended Agreed to by the Yeas and Nays: (2/3 required): 320 - 71, 1 Present (Roll no. 708). (text: CR H6762-6785)
    View Vote


  • December 12, 2023
    Motion to reconsider laid on the table Agreed to without objection.
Cathy McMorris Rodgers

Cathy McMorris Rodgers

Republican Representative

Washington

Cosponsors (3)
Jason Smith (Republican)Virginia Foxx (Republican)Frank Pallone (Democratic)

Ways and Means Committee, Health Subcommittee, Energy and Commerce Committee, Education and Workforce Committee

Health

Related Bills

  • S 118-2308: Community Health Care Reauthorization Act
  • HR 118-4883: Medicare Common Ownership Transparency Act of 2023
  • HR 118-3284: Providers and Payers COMPETE Act
  • S 118-775: Increasing Transparency in Generic Drug Applications Act
  • HR 118-3237: To amend title XVIII of the Social Security Act to require each off-campus outpatient department of a provider to include a unique identifier on claims for items and services, and to require providers with a department of a provider to submit to the Centers for Medicare & Medicaid Services an attestation with respect to each such department.
  • HR 118-3839: To amend the Federal Food, Drug, and Cosmetic Act to increase transparency in generic drug applications.
  • HR 118-4508: Hidden Fee Disclosure Act of 2023
  • S 118-1855: Special Diabetes Program Reauthorization Act of 2023
  • HR 118-2665: Supporting Safety Net Hospitals Act
  • HR 118-4527: Health DATA Act of 2023
  • Introduced
  • In Committee
  • On Floor
  • Passed Chamber
  • Enacted
Administrative law and regulatory proceduresAdvisory bodiesCivil actions and liabilityComputers and information technologyCongressional oversightConsumer affairsDepartment of Health and Human ServicesDigestive and metabolic diseasesGovernment information and archivesHealth care costs and insuranceHealth care coverage and accessHealth facilities and institutionsHealth personnelHome and outpatient careHospital careMedicaidMedicarePhotography and imagingPrescription drugsState and local government operationsSurgery and anesthesia