[Congressional Bills 118th Congress]
[From the U.S. Government Publishing Office]
[H.R. 3248 Introduced in House (IH)]
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118th CONGRESS
1st Session
H. R. 3248
To amend title XVIII of the Social Security Act to increase price
transparency of clinical diagnostic laboratory tests under the Medicare
program.
_______________________________________________________________________
IN THE HOUSE OF REPRESENTATIVES
May 11, 2023
Mrs. Miller-Meeks (for herself and Ms. DeGette) introduced the
following bill; which was referred to the Committee on Energy and
Commerce, and in addition to the Committee on Ways and Means, for a
period to be subsequently determined by the Speaker, in each case for
consideration of such provisions as fall within the jurisdiction of the
committee concerned
_______________________________________________________________________
A BILL
To amend title XVIII of the Social Security Act to increase price
transparency of clinical diagnostic laboratory tests under the Medicare
program.
Be it enacted by the Senate and House of Representatives of the
United States of America in Congress assembled,
SECTION 1. SHORT TITLE.
This Act may be cited as the ``Diagnostic Lab Testing Transparency
Act''.
SEC. 2. INCREASING PRICE TRANSPARENCY OF CLINICAL DIAGNOSTIC LABORATORY
TESTS UNDER THE MEDICARE PROGRAM.
Section 1846 of the Social Security Act (42 U.S.C. 1395w-2) is
amended--
(1) in the header, by inserting ``and additional
requirements'' after ``sanctions''; and
(2) by adding at the end the following new subsection:
``(c) Price Transparency Requirement.--
``(1) In general.--Beginning January 1, 2025, each provider
of services or supplier that is available to furnish any
specified clinical diagnostic laboratory test under this title
shall--
``(A) make publicly available on an Internet
website the information described in paragraph (2) with
respect to each such specified clinical diagnostic
laboratory test that such provider or supplier is so
available to furnish; and
``(B) ensure that such information is updated not
less frequently than annually.
``(2) Information described.--For purposes of paragraph
(1), the information described in this paragraph is, with
respect to a provider of services or supplier and a specified
clinical diagnostic laboratory test, the following:
``(A) The discounted cash price for such test (or,
if no such price exists, the gross charge for such
test).
``(B) The deidentified minimum negotiated rate in
effect between such provider or supplier and any group
health plan or group or individual health insurance
coverage for such test.
``(C) The deidentified maximum negotiated rate in
effect between such provider or supplier and any such
plan or coverage for such test.
``(3) Inclusion of ancillary services.--Any price or rate
for a specified clinical diagnostic laboratory test available
to be furnished by a provider of services or supplier made
publicly available in accordance with paragraph (1) shall
include the price or rate (as applicable) for any ancillary
item or service (such as specimen collection services) that
would normally be furnished by such provider or supplier as
part of such test, as specified by the Secretary.
``(4) Enforcement.--
``(A) In general.--In the case that the Secretary
determines that a provider of services or supplier is
not in compliance with paragraph (1)--
``(i) not later than 30 days after such
determination, the Secretary shall notify such
provider or supplier of such determination;
``(ii) not later than 90 days after such
notification is sent, such provider or supplier
shall complete a corrective action plan to
comply with such paragraph and submit such plan
to the Secretary; and
``(iii) if such provider or supplier
continues to fail to comply with such paragraph
after the date that is 90 days after such
notification is sent, the Secretary may impose
a civil monetary penalty in an amount not to
exceed $300 for each day (beginning with the
date that is 91 days after such notification
was sent) during which such failure is ongoing.
``(B) Application of certain provisions.--The
provisions of section 1128A (other than subsections (a)
and (b) of such section) shall apply to a civil
monetary penalty imposed under this paragraph in the
same manner as such provisions apply to a civil
monetary penalty imposed under subsection (a) of such
section.
``(5) Definitions.--In this subsection:
``(A) Group health plan; group health insurance
coverage; individual health insurance coverage.--The
terms `group health plan', `group health insurance
coverage', and `individual health insurance coverage'
have the meaning given such terms in section 2791 of
the Public Health Service Act.
``(B) Specified clinical diagnostic laboratory
test.--The term `specified clinical diagnostic
laboratory test' means a clinical diagnostic laboratory
test that is included on the list of shoppable services
specified by the Centers for Medicare & Medicaid
Services (as described in section 180.60 of title 42,
Code of Federal Regulations (or a successor
regulation)).''.
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