,i #aacth ,,congress #ast ,session ,h4 ,r4 #bhec ,,in ,,the ,,house ,,of ,,representatives ,july #cj1 #bjac ,mr4 ,lipinski 7for himself1 ,mr4 ,mullin1 ,mr4 ,de,fazio1 ,mr4 ,michaud1 ,mr4 ,peterson1 and ,mr4 ,polis7 introduced the following bill2 which was referred to the ,committee on ,energy and ,commerce ,a ,,bill ,to amend the ,public ,health ,service ,act to provide for the public disclosure of charges for certain hospital and ambulatory surgical center treatment episodes4 #a4 ,short title ,this ,act may be cited as the ,hospital ,price ,transparency and ,disclosure ,act of #bjac4 #b4 ,public disclosure of hospital data ,part ,b of title ,,ii of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bch et seq47 is amended by adding at the end the following new section3 #bdi4 ,data reporting by hospitals and ambulatory surgical centers and public posting 7a7 ,semiannual reporting requirement ,not later than #hj days after the end of each semiannual period beginning ,january #a or ,july #a 7beginning more than one year after the date of the enactment of this section71 a hospital and an ambulatory surgical center shall report to the ,secretary the following data3 7#a7 ,in the case of a hospital-- 7,a7 the frequency of occurrence for such hospital during such period of each treatment episode identified under subsection 7c77#a7 for a condition or disease selected under subparagraph 7,a7 or 7,b7 of such subsection 7or updated under subsection 7c77#c771 furnished in an inpatient or outpatient setting1 respectively2 and 7,b7 if care was furnished for such a treatment episode by such hospital during such period-- 7i7 the total number of such treatment episodes for which care was so furnished by the hospital during such period2 7ii7 the insured individual average charge 7as computed under subsection 7e77#c77 by the hospital for such treatment episode during such period2 and 7iii7 the uninsured individual average charge 7as computed under subsection 7e77#d77 by the hospital for such treatment episode during such period4 7#b7 ,in the case of an ambulatory surgical center-- 7,a7 the frequency of occurrence for such center during such period of each treatment episode identified under subsection 7c77#a7 for a condition or disease selected under subparagraph 7,c7 of such subsection 7or updated under subsection 7c77#c772 and 7,b7 if care was furnished for such a treatment episode by such center during such period-- 7i7 the total number of such treatment episodes for which care was so furnished by the center during such period2 7ii7 the insured individual average charge 7as computed under subsection 7e77#c77 by the center for such episode during such period2 and 7iii7 the uninsured individual average charge 7as computed under subsection 7e77#d77 by the center for such episode during such period4 7b7 ,public availability of data 7#a7 ,public posting of data ,the ,secretary shall promptly post1 on the official public ,internet site of the ,department of ,health and ,human ,services1 the data reported under subsection 7a7 and an appropriate link1 with respect to a hospital or center for which the data is reported1 to other consumer quality information maintained on such site 7or a site maintained by the ,centers for ,medicare ,medicaid ,services7 relating to the hospital or center4 ,such data shall be set forth in a manner that promotes charge comparison among hospitals and among ambulatory surgical centers4 7#b7 ,notice of availability ,a hospital and an ambulatory surgical center shall prominently post at each admission site of the hospital or center a notice of the availability of the data reported under subsection 7a7 on the official public ,internet site under paragraph 7#a74 7c7 ,specification of treatment episodes ,for purposes of this section3 7#a7 ,in general ,the ,secretary shall identify treatment episodes for each of the following3 7,a7 ,the #ajj conditions and diseases selected by the ,secretary as being the most frequently treated conditions and diseases in a hospital inpatient setting4 7,b7 ,the #ajj conditions and diseases selected by the ,secretary as being the most frequently treated conditions and diseases in a hospital outpatient setting4 7,c7 ,the #ajj conditions and diseases selected by the ,secretary as being the most frequently treated conditions and diseases in an ambulatory surgical center setting4 7#b7 ,agreement with ,,iom ,in carrying out paragraph 7#a71 the ,secretary may enter into an agreement with the ,institute of ,medicine to define a treatment episode for any condition or disease selected by the ,secretary under this subsection4 ,such a definition may take into account the varying complexity associated with respect to different treatments4 7#c7 ,updating selection ,the ,secretary shall periodically update the conditions and diseases selected under paragraph 7#a74 7d7 ,civil money penalty ,the ,secretary may impose a civil money penalty of not more than #aj1jjj for each knowing violation of subsection 7a7 or 7b77#b7 by a hospital or an ambulatory surgical center4 ,the provisions of subsection 7i77#b7 of section #cea;,a shall apply with respect to civil money penalties under this subsection in the same manner as such provisions apply to civil money penalties under subsection 7i77#a7 of such section4 7e7 ,administrative provisions 7#a7 ,in general ,the ,secretary shall prescribe such regulations and issue such guidelines as may be required to carry out this section4 7#b7 ,classification of services ,the regulations and guidelines under paragraph 7#a7 shall include rules on the classification of different treatment episodes and the assignment of items and procedures to those episodes4 7#c7 ,computation of insured individual average charges 7,a7 ,in general ,for purposes of subsections 7a77#a77;,b77ii7 and 7a77#b77;,b77ii71 an insured individual average charge for a treatment episode1 with respect to a hospital or ambulatory surgical center during a period1 shall be computed as the average of the rates 7including any applicable copayment1 coinsurance1 other cost sharing1 or other fees1 such as facility fees1 associated with treatment in the hospital or center7 for such episode that have been negotiated by the hospital or ambulatory surgical center1 respectively1 with the #e most used health insurance providers for such hospital or center during such period4 7,b7 #e most used health insurance providers ,for purposes of subparagraph 7,a71 the #e most used health insurance providers1 with respect to a hospital or ambulatory surgical center during a period1 are the #e group health plans or insurance issuers offering health insurance coverage-- 7i7 that have negotiated with the hospital or center a rate for the treatment episode involved2 and 7ii7 the enrollees of which represent the highest number of patients of the hospital or center1 respectively4 7#d7 ,computation of uninsured individual average charges 7,a7 ,in general ,for purposes of subsections 7a77#a77;,b77iii7 and 7a77#b77;,b77iii71 an uninsured individual average charge for a treatment episode1 with respect to a hospital or ambulatory surgical center during a period1 shall be computed as the average of the total amounts charged for such an episode for which care was furnished to an uninsured individual by such hospital or ambulatory surgical center during such period4 7,b7 ,uninsured individual defined ,for purposes of subparagraph 7,a71 the term uninsured individual means1 with respect to care furnished to the individual by a hospital or ambulatory surgical center1 an individual who does not have insurance or other third-party contractual benefits that provides payment for costs incurred for such care4 7#e7 ,form of report and notice ,the regulations and guidelines under paragraph 7#a7 shall specify the electronic form and manner by which a hospital or an ambulatory surgical center shall report data under subsection 7a7 and the form for posting of notices under subsection 7b77#b74 7f7 ,rules of ,construction 7#a7 ,non-preemption of ,state laws ,nothing in this section shall be construed as preempting or otherwise affecting any provision of ,state law relating to the disclosure of charges or other information for a hospital or an ambulatory surgical center4 7#b7 ,charges ,nothing in this section shall be construed to regulate or set hospital or ambulatory surgical center charges4 7g7 ,hospital and ambulatory surgical center defined ,for purposes of this section1 the terms hospital and ambulatory surgical center have the meaning given such terms by the ,secretary4 4