The "Lower Costs, More Transparency Act of 2026" aims to enhance price transparency across the U.S. healthcare system, with most provisions taking effect on January 1, 2028. This legislation mandates that various healthcare entities make their pricing information publicly accessible to empower consumers and foster competition. It introduces new requirements for hospitals, clinical diagnostic laboratories, imaging service providers, and ambulatory surgical centers. Hospitals will be required to publish all their standard charges in a machine-readable format, alongside consumer-friendly prices for at least 300 " shoppable services ." This detailed information must include gross charges, discounted cash prices , and payer-specific negotiated charges , with an attestation of accuracy. The Secretary of Health and Human Services will establish uniform methods and formats for these disclosures, ensuring accessibility for individuals with limited English proficiency. Similarly, clinical diagnostic laboratories and imaging service providers must publicly disclose discounted cash prices or gross charges for their specified services on their websites. Ambulatory surgical centers will also be subject to comprehensive transparency rules, requiring them to publish standard charges and consumer-friendly prices for shoppable services , mirroring the hospital requirements. These entities will face civil monetary penalties for non-compliance, with penalty amounts varying by facility size and duration of non-compliance, though waivers and reductions are possible under specific circumstances. Furthermore, the bill significantly expands price transparency for health coverage. Group health plans and health insurance issuers must provide participants and beneficiaries with real-time, personalized cost-sharing information for specific items and services through self-service tools . This includes details on in-network rates, out-of-network maximum allowed amounts, accumulated deductibles, and prior authorization requirements. These plans and issuers are also mandated to publicly release extensive rate and payment information in machine-readable files, updated quarterly or monthly. This data will cover in-network rates for services and drugs, average amounts paid for drugs (including " applicable spread price drugs "), and billed/allowed amounts for out-of-network services. Pharmacy benefit managers (PBMs) will be required to disclose information about " applicable spread price drugs " to health plans, shedding light on potential price discrepancies. The legislation also calls for several reports to Congress, assessing the implementation and impact of these transparency measures. These reports will cover the use of application programming interfaces (APIs) for data access, the feasibility of provider tools, compliance rates, enforcement effectiveness, and trends in negotiated prices across different market segments. Additionally, a report will explore the integration of quality data with price transparency information to provide a more holistic view for consumers.