House File 2096 - Introduced HOUSE FILE 2096 BY WILLS A BILL FOR An Act relating to the disclosure of the prices charged for 1 health services rendered by health care providers and 2 hospitals. 3 BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA: 4 TLSB 5256YH (3) 91 dg/ko

H.F. 2096 Section 1. NEW SECTION . 135.84 Disclosure of prices charged 1 for health services by health care providers and hospitals. 2 1. A health care provider shall disclose and make available 3 to the public in a single document, either electronically or 4 by posting conspicuously on the provider’s internet site, the 5 prices charged, prior to the negotiation of any discounts and 6 assuming no medical complications, for the twenty-five most 7 common health services the health care provider renders. 8 a. The health care provider shall identify the health 9 service for which prices charged are provided in both a common 10 procedural terminology code or other coding system commonly 11 used by the health care provider and accepted as a national 12 standard for billing, and in a plain language description. 13 b. The health care provider shall update the price 14 information at least once each calendar year. 15 2. A hospital shall disclose and make available to the 16 public in a single document, either electronically or by 17 posting conspicuously on the hospital’s internet site, the 18 prices charged, prior to the negotiation of any discounts and 19 assuming no medical complications, for the seventy-five most 20 common inpatient health services and the seventy-five most 21 common outpatient health services, as grouped by a Medicare 22 diagnosis-related group, rendered by the hospital. The price 23 information shall be updated on a quarterly basis. 24 3. Any price information disclosed under this section shall 25 include a disclaimer that the price information provided is 26 an estimate, does not constitute a legally binding charge for 27 a health service provided to a specific consumer, and that 28 the actual charge for a health service is dependent on the 29 circumstances at the time the health service is rendered. 30 4. The department shall adopt rules pursuant to chapter 17A 31 to ensure that requirements under this section are consistent 32 with and do not duplicate federal requirements related to the 33 disclosure of prices charged by health care providers and 34 hospitals including but not limited to the requirements for 35 -1- LSB 5256YH (3) 91 dg/ko 1/ 2

H.F. 2096 hospitals pursuant to 42 U.S.C. §300gg-18(e). 1 EXPLANATION 2 The inclusion of this explanation does not constitute agreement with 3 the explanation’s substance by the members of the general assembly. 4 This bill relates to the disclosure of prices charged by 5 health care providers (provider) and hospitals for common 6 health services (services). 7 The bill requires a provider to disclose and make available 8 to the public in a single document, either electronically or 9 on the provider’s internet site, the prices charged, prior 10 to the negotiation of any discounts and assuming no medical 11 complications, for the 25 most common services the provider 12 renders. The services are to be identified by a common 13 nationally recognized coding system and by a plain language 14 description, and the provider is required to update the price 15 information at least annually. 16 The bill requires hospitals to disclose and make available 17 to the public in a single document, either electronically or 18 on the hospital’s internet site, the prices charged, prior 19 to the negotiation of any discounts and assuming no medical 20 complications, for the 75 most common inpatient and the 75 21 most common outpatient services, as grouped by a Medicare 22 diagnosis-related group, rendered by the hospital. The price 23 information is required to be updated on a quarterly basis. 24 The bill provides that the price information disclosed 25 shall include a disclaimer that the information provided is an 26 estimate, does not constitute a legally binding charge for a 27 service provided to a specific consumer, and that the actual 28 charge for a service is dependent on the circumstances at the 29 time the service is rendered. 30 The bill directs the department of health and human services 31 to adopt rules to ensure that the bill’s requirements are 32 consistent with and do not duplicate federal requirements 33 related to the disclosure of prices charged by providers and 34 hospitals. 35 -2- LSB 5256YH (3) 91 dg/ko 2/ 2