Price transparency in health care

Summary#

This bill would require hospitals, ambulatory surgical centers, clinical laboratories, and imaging providers to post certain prices on the walls of their facilities. The main change is a new rule that, starting January 1, 2028, these facilities must display the discounted cash price (or a fallback price) for each CMS-specified “shoppable” service. The broad goal is to make out‑of‑pocket prices easier for patients to see when they are at a health care facility.

• Who is covered: hospitals, ambulatory surgical centers, clinical diagnostic laboratories (with some test exceptions), and providers/suppliers that furnish imaging services.
• What to post: the discounted cash price (the price that applies when someone pays cash) for each CMS-specified shoppable service. If no discounted cash price exists, the bill sets alternate fallback prices (median cash price for hospitals over prior 3 years, or gross charge for some labs and imaging).
• Where to post: on the wall of the facility, in areas the HHS Secretary will specify.
• When: the requirement starts January 1, 2028.
• Definitions: “Shoppable service” is a service that can be scheduled in advance and includes routine ancillary items and services.

What it means for you#

• Hospitals and outpatient departments

  • Must post on their walls the discounted cash price (or the hospital’s 3‑year median cash price for self‑pay patients if no cash price exists) for each CMS-specified shoppable inpatient and outpatient service.
  • Must follow locations for posting as set by the HHS Secretary.

• Ambulatory surgical centers

  • Must post the discounted cash price (or a 3‑year median cash price if no discounted cash price exists) for each CMS-specified shoppable service.

• Clinical laboratories

  • Must post the discounted cash price for each CMS-specified shoppable lab test that is not an “advanced diagnostic laboratory test.” If no discounted cash price exists, they must post the gross charge.

• Imaging providers and suppliers

  • Must post the discounted cash price for each CMS-specified shoppable imaging service, or the gross charge if no discounted cash price exists.

• Patients (including self-pay patients)

  • May see posted cash prices for shoppable services when at the facility. This could help someone paying cash know a price before receiving the service.
  • The posted price applies to paying in cash (or cash equivalent). The bill does not require posting insurer-negotiated rates or estimates of what an insured patient would owe.

• Government agencies

  • The HHS Secretary must specify where in facilities prices must be posted. The bill does not state how the Secretary will enforce the rule.

Expenses#

No publicly available information.

• The bill itself does not include a fiscal note or cost estimate.
• Likely costs that facilities may face include collecting price data, deciding fallback prices, designing and printing or mounting wall displays, and staff time to update prices.
• The Secretary (HHS) may need to issue guidance and possibly monitor compliance; those actions could carry administrative costs, but the bill does not describe funding or enforcement resources.
• The bill does not state penalties, fines, or who will pay for enforcement.

Proponents' View#

• The bill appears intended to increase price transparency at the point of care by making cash prices visible inside facilities.
• This could be seen as helping people who pay out of pocket compare prices and plan for shoppable services.
• Posting prices on-site could make price information easier to find than relying only on online tools or bills.

Opponents' View#

• One concern is that the bill does not explain enforcement or penalties. It is unclear how compliance will be checked or enforced.
• The bill does not require posting insurer-negotiated rates or estimates for insured patients, so posted cash prices may not reflect what insured patients will actually owe.
• The fallback price rules differ by setting (median cash price for hospitals; gross charge for labs and imaging), which could cause confusion.
• It is unclear how often displayed prices must be updated and how to handle price variability, bundled services, or patient-specific factors.
• Facilities will likely incur administrative and display costs to compile and keep prices current; the bill provides no funding or cost estimates.