Pennsylvania HB 1266: An Act amending the act of July 19, 1979 (P.L.130, No.48), known as the Health Care Facilities Act, in licensing of health care facilities, providing for hospital pricing transparency; providing for acquisition of health care facilities; and conferring powers to the Department of Health and Attorney General.

Bill Text

PRINTER'S NO. 1409
THE GENERAL ASSEMBLY OF PENNSYLVANIA
HOUSE BILL
No. 1266
Session of
2025
INTRODUCED BY D. WILLIAMS, HOWARD, SHUSTERMAN, GIRAL, HILL-
EVANS, PIELLI, DONAHUE, SAPPEY, BOYD, GUENST, SANCHEZ, OTTEN,
MAYES, HANBIDGE, BURNS, BOROWSKI, O'MARA, WEBSTER, K.HARRIS,
NEILSON AND CEPEDA-FREYTIZ, APRIL 17, 2025
REFERRED TO COMMITTEE ON HEALTH, APRIL 17, 2025
AN ACT
Amending the act of July 19, 1979 (P.L.130, No.48), entitled "An
act relating to health care; prescribing the powers and
duties of the Department of Health; establishing and
providing the powers and duties of the State Health
Coordinating Council, health systems agencies and Health Care
Policy Board in the Department of Health, and State Health
Facility Hearing Board in the Department of Justice;
providing for certification of need of health care providers
and prescribing penalties," in licensing of health care
facilities, providing for hospital pricing transparency;
providing for acquisition of health care facilities; and
conferring powers to the Department of Health and Attorney
General.
The General Assembly of the Commonwealth of Pennsylvania
hereby enacts as follows:
Section 1. The act of July 19, 1979 (P.L.130, No.48), known
as the Health Care Facilities Act, is amended by adding a
section to read:
Section 823 . Hospital pricing transparency.
(a) Requirement generally.--No later than six months after
the effective date of this subsection, a hospital or hospital
system shall establish, update and publish on the publicly
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22

accessible Internet website of the hospital or hospital system,
a list of standard charges for each item or service provided as
required under 42 U.S.C. § 300gg-18(e) (relating to bringing
down the cost of health care coverage).
(b) Required data elements.--A hospital or hospital system
shall include all of the following corresponding data elements
in a list of standard charges for the hospital or hospital
system , as applicable:
(1) A description of each item or service provided by
the hospital or hospital system.
(2) The gross charge that applies to each individual
item or service when provided in, as applicable, the hospital
inpatient setting and outpatient department setting.
(3) The payer-specific negotiated charge that applies to
each item or service when provided in, as applicable, the
hospital inpatient setting and outpatient department setting.
Each payer-specific negotiated charge must be clearly
associated with the name of the third-party payer and plan.
(4) The de-identified minimum negotiated charge that
applies to each item or service when provided in, as
applicable, the hospital inpatient setting and outpatient
department setting.
(5) The de-identified maximum negotiated charge that
applies to each item or service when provided in, as
applicable, the hospital inpatient setting and outpatient
department setting.
(6) The discounted cash price that applies to each item
or service when provided in, as applicable, the hospital
inpatient setting and outpatient department setting.
(7) Any code used by the hospital or hospital system for
20250HB1266PN1409 - 2 -
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30

purposes of accounting or billing for the item or service,
including the Current Procedural Terminology code, the
Healthcare Common Procedure Coding System code, the Diagnosis
Related Group, the National Drug Code or other common payer
identifier.
(c) Continued obligation.--A hospital or hospital system
shall continue to publish charges and services if:
(1) 42 U.S.C. § 300gg-18(e) is repealed; or
(2) Federal enforcement of 42 U.S.C. § 300gg-18 is
stopped.
(d) Definitions.--As used in this section, the following
words and phrases shall have the meanings given to them in this
subsection unless the context clearly indicates otherwise:
"De-identified maximum negotiated charge." The highest
charge that a hospital or hospital system has negotiated with
all third-party payers for an item or service.
"De-identified minimum negotiated charge." The lowest charge
that a hospital or hospital system has negotiated with all
third-party payers for an item or service.
"Discounted cash price." The charge that applies to an
individual who pays cash or a cash equivalent for a hospital
item or service.
"Gross charge." The charge for an individual item or service
that is reflected on a hospital's chargemaster, absent any
discounts.
"Item or service." As follows:
(1) Each item or service, including an individual item
or service or service package, that could be provided by a
hospital to a patient in connection with an inpatient
admission or an outpatient department visit for which the
20250HB1266PN1409 - 3 -
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30

hospital has established a standard charge.
(2) The term includes, without limitation, the
following:
(i) Any supply or procedure.
(ii) Room and board.
(iii