Bill Sponsor
House Bill 5378
118th Congress(2023-2024)
Lower Costs, More Transparency Act
Active
Active
Passed House on Dec 11, 2023
Overview
Text
Introduced
Sep 8, 2023
Latest Action
Dec 11, 2023
Origin Chamber
House
Type
Bill
Bill
The primary form of legislative measure used to propose law. Depending on the chamber of origin, bills begin with a designation of either H.R. or S. Joint resolution is another form of legislative measure used to propose law.
Bill Number
5378
Congress
118
Policy Area
Health
Health
Primary focus of measure is science or practice of the diagnosis, treatment, and prevention of disease; health services administration and funding, including such programs as Medicare and Medicaid; health personnel and medical education; drug use and safety; health care coverage and insurance; health facilities. Measures concerning controlled substances and drug trafficking may fall under Crime and Law Enforcement policy area.
Sponsorship by Party
Republican
Washington
Republican
Missouri
Democrat
New Jersey
Republican
North Carolina
House Votes (1)
Senate Votes (0)
checkPassed on December 12, 2023
Question
On Motion to Suspend the Rules and Pass, as Amended
Status
Passed
Type
Roll Call Vote
Roll Call Vote
A vote that records the individual position of each Member who voted. Such votes occurring on the House floor (by the "yeas and nays" or by "recorded vote") are taken by electronic device. The Senate has no electronic voting system; in such votes, Senators answer "yea" or "nay" as the clerk calls each name aloud. Each vote is compiled by clerks and receives a roll call number (referenced in Congress.gov as a "Record Vote" [Senate] or "Roll no." [House]).
Roll Call Type
2/3 Yea-And-Nay
Roll Number
708
House Roll Call Votes
Summary

Lower Costs, More Transparency Act

This bill requires health care providers and insurers to disclose certain information about health care costs. It also establishes requirements for certain payment methodologies under Medicare and Medicaid and extends several public health programs.

For example, the bill provides statutory authority for regulations that require hospitals to annually publish their prices and related information, including the discounted cash price and negotiated charges. The bill also specifically extends these requirements to clinical laboratories, imaging service providers, and ambulatory surgical centers that participate in Medicare. Additionally, pharmacy benefit managers (PBMs) must semiannually report to health plan sponsors on the number and types of claims for covered drugs, including whether the drugs were brand-name or generic drugs and associated costs. Contracts with PBMs for employer-sponsored health plans must also allow health plan fiduciaries to audit certain claims and cost information without undue restrictions.

In addition, the bill requires pass-through pricing models, and prohibits spread-pricing, for payment arrangements with PBMs under Medicaid. It also requires Medicare payments for certain drug administration services at off-campus hospital outpatient departments to be the same as that for other provider settings (i.e., physician offices).

The bill provides funds for the Department of Health and Human Services, the Department of Treasury, and the Department of Labor to implement and enforce the bill's requirements.

Finally, the bill extends several public health programs, including the Teaching Health Center Graduate Medical Education Program (through FY2030) and the National Health Service Corps (through December 31, 2025).

Text (2)
December 11, 2023
September 8, 2023