,i  #aafth ,,congress  #b;d ,session    
,h4 ,r4 #fjje  ,,in ,,the ,,house ,,of  
,,representatives  ,february #bg1       
#bjbj,mr4 ,malinowski 7for himself and  
,mr4 ,bucshon7 introduced the following 
bill2 which was referred to the         
,committee on ,energy and ,commerce  ,a 
,,bill  ,to amend title ,,xxvii of the  
,public ,health ,service ,act to        
increase transparency of group health   
plans and health insurance issuers      
offering group or individual health     
insurance coverage by removing gag      
clauses on price and quality            
information1 and for other purposes4    
#a4 ,short title ,this ,act may be cited
 as the ,know the ,price ,act4  #b4     
,increasing transparency by removing gag
 clauses on price and quality           
information ,subpart ,,ii of part ,a of 
title ,,xxvii of the ,public ,health    
,service ,act 7#db ,u4,s4,c4 #cjj;gg-#aa
 et seq47 is amended by adding at the   
end the following3  #bgbi;,a4           
,increasing transparency by removing gag

 clauses on price and quality           
information  7a7 ,increasing price and  
quality transparency for plan sponsors  
and consumers  7#a7 ,group health plans 
,a group health plan or a health        
insurance issuer offering group health  
insurance coverage may not enter into an
 agreement with a health care provider1 
network or association of providers1    
third-party administrator1 or other     
service provider offering access to a   
network of providers that would directly
 or indirectly restrict a group health  
plan or health insurance issuer from--  
7,a7 providing provider-specific cost or
 quality of care information1 through a 
consumer engagement tool or any other   
means1 to referring providers1 the plan 
sponsor1 enrollees1 or eligible         
enrollees of the plan or coverage2  7,b7
 electronically accessing de-identified 
claims and encounter data for each      
enrollee in the plan or coverage1 upon  
request and consistent with the privacy 
regulations promulgated pursuant to     

section #bfd7;c7 of the ,health         
,insurance ,portability and             
,accountability ,act1 the amendments to 
this ,act made by the ,genetic          
,information ,nondiscrimination ,act of 
#bjjh1 and the ,americans with          
,disabilities ,act of #aiij1 with       
respect to the applicable health plan or
 health insurance coverage1 including1  
on a per claim basis-- 7i7 financial    
information1 such as the allowed amount1
 or any other claim-related financial   
obligations included in the provider    
contract2  7ii7 provider information1   
including name and clinical designation2
  7iii7 service codes2 or  7iv7 any     
other data element normally included in 
claim or encounter transactions when    
received by a plan or issuer2 or  7,c7  
sharing data described in subparagraph  
7,a7 or 7,b7 with a business associate  
as defined in section #afj4ajc of title 
#de1 ,code of ,federal ,regulations 7or 
successor regulations71 consistent with 
the privacy regulations promulgated     

pursuant to section #bfd7;c7 of the     
,health ,insurance ,portability and     
,accountability ,act1 the amendments to 
this ,act made by the ,genetic          
,information ,nondiscrimination ,act of 
#bjjh1 and the ,americans with          
,disabilities ,act of #aiij4  7#b7      
,individual health insurance coverage ,a
 health insurance issuer offering       
individual health insurance coverage may
 not enter into an agreement with a     
health care provider1 network or        
association of providers1 or other      
service provider offering access to a   
network of providers that would1        
directly or indirectly restrict the     
health insurance issuer from-- 7,a7     
providing provider-specific price or    
quality of care information1 through a  
consumer engagement tool or any other   
means1 to referring providers or the    
plan sponsor1 enrollees1 or eligible    
enrollees of the plan or coverage2 or   
7,b7 sharing data described in          
subparagraph 7,a7 with a business       

associate as defined in section #afj4ajc
 of title #de1 ,code of ,federal        
,regulations 7or successor regulations71
 consistent with the privacy regulations
 promulgated pursuant to section        
#bfd7;c7 of the ,health ,insurance      
,portability and ,accountability ,act1  
the amendments to this ,act made by the 
,genetic ,information ,nondiscrimination
 ,act of #bjjh1 and the ,americans with 
,disabilities ,act of #aiij1 for plan   
design1 plan administration1 and plan1  
financial1 legal1 and quality           
improvement activities4  7#c7           
,clarification regarding public         
disclosure of information ,nothing in   
paragraph 7#a77;,a7 or 7#b77;,a7        
prevents a health care provider1 network
 or association of providers1 or other  
service provider from placing reasonable
 restrictions on the public disclosure  
of the information described in such    
paragraphs 7#a7 and 7#b74  7#d7         
,attestation ,a group health plan or a  
health insurance issuer offering group  

or individual health insurance coverage 
shall annually submit to1 as applicable1
 the applicable authority described in  
section #bgbc or the ,secretary of      
,labor1 an attestation that such plan or
 issuer is in compliance with the       
requirements of this subsection4  7#e7  
,rule of construction ,nothing in this  
section shall be construed to otherwise 
limit group health plan or plan sponsor 
access to data currently permitted under
 the privacy regulations promulgated    
pursuant to section #bfd7;c7 of the     
,health ,insurance ,portability and     
,accountability ,act1 the amendments to 
this ,act made by the ,genetic          
,information ,nondiscrimination ,act of 
#bjjh1 and the ,americans with          
,disabilities ,act of #aiij4  4