S. 1827

Hospital Price Reporting and Disclosure Act of 2005

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II

109th CONGRESS

1st Session

S. 1827

IN THE SENATE OF THE UNITED STATES

October 6, 2005

Mr. DeMint (for himself, Mr. Durbin, and Mr. Cornyn) introduced the following bill; which was read twice and referred to the Committee on Health, Education, Labor, and Pensions

A BILL

To amend the Public Health Service Act to provide for the public disclosure of charges for certain hospital services and drugs.

1.

Short title

This Act may be cited as the Hospital Price Reporting and Disclosure Act of 2005.

2.

Public disclosure of hospital data

Part B of title II of the Public Health Service Act (42 U.S.C. 238 et seq.) is amended by adding at the end the following new section:

249.

Data reporting by hospitals and public posting

(a)

Semiannual reporting requirement

Not later than 80 days after the end of each semiannual period beginning January 1 or July 1 (beginning more than one year after the date of the enactment of this section), a hospital shall report to the Secretary the following data:

(1)

The frequency with which the hospital performed each service selected under subparagraph (A) or (B) of subsection (c)(1) in an inpatient or outpatient setting, respectively, during such period.

(2)

The frequency with which the hospital administered a drug selected under subparagraph (C) of such subsection in an inpatient setting during such period.

(3)

If the service was so performed or the drug was so administered during such period, the average charge and the medium charge by the hospital for such service or drug during such period.

(b)

Public availability of data

(1)

Public posting of data

The Secretary shall promptly post, on the official public Internet site of the Department of Health and Human Services, the data reported under subsection (a). Such data shall be set forth in a manner that promotes charge comparison among hospitals.

(2)

Notice of availability

A hospital shall prominently post at each admission site of the hospital a notice of the availability of the data reported under subsection (a) on the official public Internet site under paragraph (1).

(c)

Selection of services and drugs

For purposes of this section:

(1)

Initial selection

Based on national data, the Secretary shall select the following:

(A)

The 25 most frequently performed services in a hospital inpatient setting.

(B)

The 25 most frequently performed services in a hospital outpatient setting.

(C)

The 50 most frequently administered drugs in a hospital inpatient setting.

(2)

Updating selection

The Secretary shall periodically update the services and drugs selected under paragraph (1).

(d)

Civil money penalty

The Secretary may impose a civil money penalty of not more than $10,000 for each knowing violation of subsection (a) or (b)(2) by a hospital. The provisions of subsection (i)(2) of section 351A 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 (i)(1) of such section.

(e)

Administrative provisions

(1)

In general

The Secretary shall prescribe such regulations and issue such guidelines as may be required to carry out this section.

(2)

Classification of services

The regulations and guidelines under paragraph (1) shall include rules on the classification of different services and the assignment of items and procedures to those services (including inpatient diagnostic related groups (DRGs), outpatient procedures, and tests) and classification of drugs. For purposes of the preceding sentence, classification of drugs may include unit, strength, and dosage information.

(3)

Computation of average and median charges

(A)

In general

The regulations and guidelines under paragraph (1) shall include a methodology for computing an average charge and a median charge for a service or drug, in accordance with subparagraph (B).

(B)

Methodology

The methodology prescribed by the Secretary under subparagraph (A) shall ensure that the average charge and the median charge for a service or drug reflect the amount charged before any adjustment based on a rate negotiated with a third party.

(4)

Form of report and notice

The regulations and guidelines under paragraph (1) shall specify the electronic form and manner by which a hospital shall report data under subsection (a) and the form for posting of notices under subsection (b)(2).

(f)

Rules of Construction

(1)

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.

(2)

Charges

Nothing in this section shall be construed to regulate or set hospital charges.

(g)

Definitions

For purposes of this section:

(1)

Hospital

The term hospital has the meaning given such term by the Secretary.

(2)

Drug

The term drug includes a biological and a non-prescription drug, such as an ointment.

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