Recently, Congress has introduced several pieces of legislation aimed at increasing price transparency among health facilities and insurers, including three iterations of the Patients Deserve Price Tags Act currently under debate—though the two House versions contain lighter requirements and broader exemptions. NRHA does not support imposing additional federal price transparency requirements on rural hospitals due to the significant administrative burden they create; however, if Congress chooses to advance such policies, NRHA urges careful consideration of the following provisions to avoid exacerbating rural access challenges: 

• Allow deemed compliance with a price estimator tool and require hospitals to include a disclaimer that the price estimator tools can only provide estimates and that actual costs may vary. 
• Require the Secretary to provide technical assistance if requested. Provide financial assistance and resources to rural hospitals who do not have the resources to comply with additional administrative burdens.
• Require annual updates, instead of quarterly, to align statutory requirements with current CMS guidance.
• Allow the Secretary to waive penalties and provide hardship exemptions, especially for rural hospitals and facilities. 

 

S.2355, the Patient’s Deserve Price Tags Act. (Passed the Health, Education, Labor, and Pensions Committee). This bill would amend the Public Health Service Act to provide hospital and insurer price transparency through quarterly public price disclosure and itemized billing mandates on all hospitals. The most stringent of the three, it requires quarterly updates, does not permit price estimator tools, covers all CMS shoppable services, offers no hardship exemptions, and does not require the Secretary to provide technical assistance. Noncompliant hospitals would face immediate corrective action plan and/or civil monetary penalty action from the Secretary, with no discretion or grace period.

H.R. 9393, the Lower Costs, More Transparency Act of 2026. (Passed the Energy and Commerce Committee). This bill seeks to increase price transparency by requiring annual updates, as well as addressing the cost of prescription drugs among other provisions. It requires only yearly updates and covers a narrower set of 300 shoppable services. While it still bars price estimator tools, it softens enforcement by giving the Secretary discretion to issue CAPs before a CMP becomes mandatory upon continued noncompliance. Hospitals could also claim hardship exemptions and would be entitled to technical assistance. 

H.R. 9645, the Health Care Price Certainty for All Americans Act. (Passed the Ways and Means Committee). This legislation codifies and expands healthcare price transparency requirements for hospitals, labs, imaging providers, ambulatory surgery centers (ASCs), group health plans/issuers and pharmacy benefit managers (PBMs). Like H.R. 9393, it requires only yearly updates, covers 300 shoppable services, allows hardship exemptions, and entitles hospitals to technical assistance on request, with the same discretionary CAP then mandatory CMP enforcement structure, but it stands apart as the only one of the three that permits hospitals to use price estimator tools.

PDPT	LCMT	HCPCA
Quarterly Updates	Yearly updates	Yearly updates
Price estimator tool not allowed	Price estimator tool not allowed	Price estimator tool allowed
Secretary provides CAP/CMP to all noncompliant hospitals immediately	Secretary may provide a CAP to noncompliant hospitals, must provide CMP if continued	Secretary may provide a CAP to noncompliant hospitals, must provide CMP if continued
All CMS shoppable services	300 shoppable services	300 shoppable services
No hardship exemptions	Hardship exemptions	Hardship exemptions
No TA required	TA required if requested	TA required if requested

Please find NRHA’s letters to Congress on the Patients Deserve Price Tags Act here.

Please find NRHA’s letters to Congress on the Lower Costs, More Transparency Act here.