[Congressional Bills 109th Congress]
[From the U.S. Government Publishing Office]
[H.R. 1362 Introduced in House (IH)]






109th CONGRESS
  1st Session
                                H. R. 1362

  To amend title XVIII of the Social Security Act to provide for the 
public disclosure of prices for hospital and ambulatory surgical center 
                         procedures and drugs.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                             March 17, 2005

Mr. Lipinski (for himself and Mr. Inglis of South Carolina) introduced 
  the following bill; which was referred to the Committee on Ways and 
 Means, and in addition to the Committee on Energy and Commerce, 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 provide for the 
public disclosure of prices for hospital and ambulatory surgical center 
                         procedures and drugs.

    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 ``Hospital Price Disclosure Act of 
2005''.

SEC. 2. PUBLIC DISCLOSURE OF HOSPITAL AND AMBULATORY SURGICAL CENTER 
              DATA.

    (a) Requirement.--
            (1) Hospitals.--Subsection (a)(1) of section 1866 of the 
        Social Security Act (42 U.S.C. 1395cc) is amended--
                    (A) in subparagraph (U), by striking ``and'' at the 
                end;
                    (B) in subparagraph (V), by striking the period at 
                the end and inserting ``, and''; and
                    (C) by inserting after subparagraph (V) the 
                following new subparagraph:
            ``(W) in the case of a hospital, to report to the Secretary 
        data in accordance with subsection (k)(1) and to post notice 
        regarding such data in accordance with subsection (k)(2)(B).''.
            (2) Ambulatory surgical centers.--Section 1832(a)(2)(F)(i) 
        of such Act (42 U.S.C. 1395k(a)(2)(F)(i)) is amended by 
        inserting after ``other standards'' the following: ``, 
        including the reporting to the Secretary of data in accordance 
        with section 1866(k)(1) and the posting of notice regarding 
        such data in accordance with section 1866(k)(2)(B)''.
    (b) Data Reporting by Hospitals and Ambulatory Surgical Centers for 
Certain Inpatient and Outpatient Procedures and Inpatient Drugs.--
Section 1866 of such Act (42 U.S.C. 1395cc) is further amended by 
adding at the end the following new subsection:
    ``(k) Data Reporting by Hospitals and Ambulatory Surgical Centers 
and Public Posting.--
            ``(1) Quarterly reporting requirement.--Not later than 45 
        days after the end of each calendar quarter (beginning more 
        than one year after the date of the enactment of this 
        subsection), a hospital shall report to the Secretary, for each 
        procedure or drug selected under paragraph (3), and an 
        ambulatory surgical center shall report to the Secretary, for 
        each procedure selected under paragraph (3)(A)(ii), the 
        following data:
                    ``(A) The frequency with which the hospital 
                performed the procedure, or administered the drug in an 
                inpatient setting, or the center performed the 
                procedure during such quarter.
                    ``(B) If the procedure was performed or the drug 
                was so administered during such quarter, the average 
                and the median of the price charged by the hospital or 
                center for such procedure or drug during such quarter.
            ``(2) Public availability of data.--
                    ``(A) Public posting of data.--The Secretary shall 
                promptly post, on the official public Internet site of 
                the Department of Health and Human Services, the data 
                reported under paragraph (1). Such data shall be set 
                forth in a manner that promotes price comparison among 
                hospitals and ambulatory surgical centers.
                    ``(B) Notice of availability.--A hospital and 
                ambulatory surgical center shall prominently post at 
                each admission site of the hospital or center a notice 
                of the availability of the data reported under 
                paragraph (1) on the official public Internet site 
                under subparagraph (A).
            ``(3) Selection of procedures and drugs.--
                    ``(A) Initial selection.--Based on national data, 
                the Secretary shall select the following:
                            ``(i) The 25 most frequently performed 
                        hospital inpatient procedures.
                            ``(ii) The 25 most frequently performed 
                        hospital outpatient procedures.
                            ``(iii) The 50 most frequently administered 
                        drugs in a hospital inpatient setting.
                    ``(B) Updating selection.--The Secretary shall 
                periodically update the procedures and drugs selected 
                under subparagraph (A).
            ``(4) Civil money penalty.--The Secretary may impose a 
        civil money penalty of not more than $10,000 for each knowing 
        violation of the provisions of paragraph (1) or (2)(B) by a 
        hospital or ambulatory surgical center. A civil money penalty 
        under this paragraph shall be imposed and collected in the same 
        manner as a civil money penalty under subsection (a) of section 
        1128A is imposed and collected under that section.
            ``(5) Administrative provisions.--
                    ``(A) Classification of procedures.--For purposes 
                of this subsection, the Secretary shall establish rules 
                for the classification of different procedures and for 
                the assignment of items and services to those 
                procedures.
                    ``(B) Computation of average and median prices.--
                For purposes of paragraph (1), the computation of an 
                average and median price for a procedure or drug shall 
                be in accordance with a methodology prescribed by the 
                Secretary. Such methodology may provide for reporting 
                by the hospital or ambulatory surgical center of unit 
                prices for specific items and services included in a 
                procedure, including appropriate per diem prices, and a 
                method of converting such unit prices for a procedure 
                to an average and median price for such procedure.
                    ``(C) Form of report and notice.--The Secretary 
                shall specify the electronic form and manner by which a 
                hospital or ambulatory surgical center shall report 
                data under paragraph (1) and the form for posting of 
                notices under paragraph (2)(B).
            ``(6) Non-preemption of state laws.--Nothing in this 
        subsection shall be construed as preempting or otherwise 
        affecting any provision of State law relating to the disclosure 
        of price or other information for a hospital or ambulatory 
        surgical center.
            ``(7) Drug defined.--For purposes of this subsection, the 
        term `drug' includes a biological and a non-prescription drug, 
        such as an ointment. ''.
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