Sec. 103. Imaging price transparency
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/bill/118/hr/5378/ih/section-103A research copy — for the controlling text, always check the official state or federal source. Not legal advice.
Section 1899C of the Social Security Act, as added by section 101, is amended— by redesignating subsection
(b)as subsection (c); by inserting after subsection
(a)the following new subsection: Beginning January 1, 2028, each provider of services and supplier that receives payment under this title for furnishing a specified imaging service, other than such a provider or supplier with respect to which standard charges and prices for such services furnished by such provider or supplier are made available by a hospital pursuant to section 1899C or section 2718(f) of the Public Health Service Act, shall— make publicly available (in accordance with paragraph (3)) on an internet website the information described in paragraph
(2)with respect to each such service that such provider of services or supplier furnishes; and ensure that such information is updated not less frequently than annually. For purposes of paragraph (1), the information described in this paragraph is, with respect to a provider of services or supplier and a specified imaging service, the following: The discounted cash price for such service (or, if no such price exists, the gross charge for such service). If required by the Secretary, the deidentified minimum payer-specific negotiated charge for such service and the deidentified maximum payer-specific negotiated charge for such service. Not later than January 1, 2028, the Secretary shall establish a standard, uniform method and format for providers of services and suppliers to use in making public information described in paragraph (2). Any such method and format— may be similar to any template made available by the Centers for Medicare & Medicaid Services (as described in section 1899C(a)(2)(C)(ii)); shall meet such standards as determined appropriate by the Secretary in order to ensure the accessibility and usability of such information; and shall be updated as determined appropriate by the Secretary, in consultation with stakeholders. The Secretary shall, through notice and comment rulemaking and in consultation with the Inspector General of the Department of Health and Human Services, establish a process to monitor compliance with this subsection. In the case that the Secretary determines that a provider of services or supplier is not in compliance with paragraph (1)— not later than 30 days after such determination, the Secretary shall notify such provider or supplier of such determination; upon request of the Secretary, such provider or supplier shall submit to the Secretary, not later than 45 days after the date of such request, a corrective action plan to comply with such paragraph; and if such provider or supplier continues to fail to comply with such paragraph after the date that is 90 days after such notification is sent (or, in the case of such a provider or supplier that has submitted a corrective action plan described in clause
(ii)in response to a request so described, after the date that is 90 days after such submission), the Secretary may impose a civil monetary penalty in an amount not to exceed $300 for each day (beginning with the day on which the Secretary first determined that such provider or supplier was failing to comply with such paragraph) during which such failure to comply or failure to submit is ongoing. In applying this paragraph with respect to violations occurring in 2029 or a subsequent year, the Secretary may through notice and comment rulemaking increase the amount of the civil monetary penalty under subparagraph (A)(iii). The provisions of section 1128A (other than subsections
(a)and
(b)of such section) shall apply to a civil monetary penalty imposed under this paragraph in the same manner as such provisions apply to a civil monetary penalty imposed under subsection
(a)of such section. Subject to clause (ii), the Secretary may waive or reduce any penalty otherwise applicable with respect to a provider of services or supplier under this subparagraph if the Secretary certifies that imposition of such penalty would result in an immediate threat to access to care for individuals in the service area of such provider or supplier. The Secretary may not elect to waive or reduce a penalty under clause
(i)with respect to a specific provider of services or supplier more than 3 times. The Secretary shall, to the extent practicable, provide technical assistance relating to compliance with the provisions of this subsection to providers of services and suppliers requesting such assistance. Notwithstanding any other provision of this title, this paragraph shall be the sole means of enforcing the provisions of this subsection. ; and in subsection (c), as so redesignated by paragraph (1)— by redesignating paragraph
(8)as paragraph (9); and by inserting after paragraph
(7)the following new paragraph: the term specified imaging service means an imaging service that is a Centers for Medicare & Medicaid Services-specified shoppable service (as described in subsection (a)(2)(A)(ii)(I)). .