,i  #aaith ,,congress  #ast ,session    
,h4 ,r4 #cjag  ,,in ,,the ,,house ,,of  
,,representatives  ,april #bd1          
#bjbe,mrs4 ,spartz introduced the       
following bill2 which was referred to   
the ,committee on ,energy and ,commerce 
,a ,,bill  ,to direct the ,assistant    
,secretary for ,planning and ,evaluation
 of the ,department of ,health and      
,human ,services to conduct an annual   
study on health care competition and    
consolidation at the ,state level4  #a4 
,short title ,this ,act may be cited as 
the ,measuring ,state ,healthcare       
,freedom ,act4  #b4 ,annual study on    
health care competition and             
consolidation at ,state level  7a7 ,in  
general ,over each of the #aj years     
following the date of enactment of this 
,act1 the ,assistant ,secretary for     
,planning and ,evaluation of the        
,department of ,health and ,human       
,services 7in this section referred to  
as the ,assistant ,secretary7 shall     
conduct a study on health care          

competition and consolidation at the    
,state level4  7b7 ,consultation ,in    
conducting the study under this section1
 the ,assistant ,secretary shall consult
 with the ,chair of the ,federal ,trade 
,commission and the ,assistant ,attorney
 ,general in charge of the ,antitrust   
,division of the ,department of         
,justice4  7c7 ,obtaining data ,the     
,assistant ,secretary may secure from   
the ,federal ,trade ,commission         
information necessary to enable the     
,assistant ,secretary to carry out      
subsection 7d77#b74 ,upon request of the
 ,assistant ,secretary1 the ,chair of   
the ,federal ,trade ,commission shall   
furnish that information to the         
,assistant ,secretary4  7d7 ,metrics    
,the study under this section shall     
include data collection on each of the  
following3 7#a7 ,licensing requirements 
for doctors1 nurses1 and other health   
care practitioners1 including           
requirements with respect to-- 7,a7     
initial licensure2  7,b7 ongoing        

maintenance of licensure2  7,c7 specific
 training and postgraduate and          
continuing medical education2  7,d7     
residency supervisory requirements2 and 
7,e7 board certification4  7#b7 ,mergers
 and acquisitions 7both vertical and    
horizontal71 involving-- 7,a7 hospitals2
  7,b7 ambulatory or outpatient         
practices2  7,c7 ambulatory surgical    
centers2  7,d7 health insurance         
providers2  7,e7 habilitative service   
providers 7such as providers of physical
 therapy or occupational therapy72 and  
7,f7 telehealth4  7#c7 ,the number of-- 
7,a7 ,state laws establishing a legal   
mechanism by which a ,state approves    
mergers between or among two or more    
hospitals 7commonly referred to as      
certificates of public advantage72 and  
7,b7 ,state laws establishing a legal   
mechanism for regulating the growth of  
construction of new health care         
facilities 7commonly referred to as     
certificates of need74  7#d7 ,the       
availability of alternative forms of    

health insurance coverage1 including--  
7,a7 short-term limited duration        
insurance 7as defined for purposes of   
section #bgia7;b77#e7 of the ,public    
,health ,service ,act 7#db ,u4,s4,c4    
#cjj;gg-#ia7;b77#e7772 and  7,b7        
association health plans 7including     
plans offered through the ,american     
,farm ,bureau ,federation74  7#e7 ,the  
number of each of the following in      
operation at the start and the end of   
each year covered by the #aj-year study 
period3 7,a7 ,hospitals4  7,b7 ,medical 
practices4  7,c7 ,ambulatory or         
outpatient practices4  7,d7 ,ambulatory 
surgical centers4  7,e7 ,health         
insurance providers4  7,f7 ,habilitative
 service providers4  7#f7 ,the          
,herfindahl-,hirschman ,index1 within   
geographic areas defined by the         
,assistant ,secretary in consultation   
with the ,bureau of ,competition of the 
,federal ,trade ,commission1 for the    
following health care services3 7,a7    
,general acute care hospital services4  

7,b7 ,ambulatory or outpatient medical  
services1 disaggregated by medical      
specialty4  7,c7 ,habilitative services4
  7e7 ,annual reports  7#a7 ,in general 
,not later than the end of each of the  
#aj years referred to in subsection 7a71
 the ,assistant ,secretary shall submit 
to the ,committee on ,energy and        
,commerce and the ,committee on ,ways   
and ,means of the ,house of             
,representatives and the ,committee on  
,finance and the ,committee on ,health1 
,education1 ,labor1 and ,pensions of the
 ,senate a report on the status and     
results of the study under this section4
  7#b7 ,publication2 publicly accessible
 datasets ,not later than the end of    
each of the #aj years referred to in    
subsection 7a71 the ,assistant          
,secretary shall-- 7,a7 publish on the  
website of the ,office of the ,assistant
 ,secretary the report submitted under  
paragraph 7#a7 for the respective year2 
and  7,b7 make the data collected       
through the study under this section    

available to the public on such website 
in a manner that is publicly accessible 
and interactive4