[Congressional Bills 118th Congress]
[From the U.S. Government Publishing Office]
[H.R. 3262 Introduced in House (IH)]

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118th CONGRESS
  1st Session
                                H. R. 3262

 To amend title XI of the Social Security Act to increase transparency 
            of certain health-related ownership information.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                              May 11, 2023

Ms. Schakowsky (for herself and Mr. Bilirakis) 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 XI of the Social Security Act to increase transparency 
            of certain health-related ownership information.

    Be it enacted by the Senate and House of Representatives of the 
United States of America in Congress assembled,

SECTION 1. MANDATORY REPORTING WITH RESPECT TO CERTAIN HEALTH-RELATED 
              OWNERSHIP INFORMATION.

    Part A of title XI of the Social Security Act (42 U.S.C. 1301 et 
seq.) is amended by adding at the end the following new section:

``SEC. 1150D. MANDATORY REPORTING WITH RESPECT TO CERTAIN HEALTH-
              RELATED OWNERSHIP INFORMATION.

    ``(a) Mandatory Reporting With Respect Certain Health-Related 
Ownership Information.--
            ``(1) Initial report.--Not later than January 1, 2025 (or 
        in the case of a specified entity formed after January 1, 2025, 
        within 60 days of becoming a specified entity), each specified 
        entity (as defined in subsection (f)(5)) shall submit to the 
        Secretary, in a form and manner specified by the Secretary, a 
        report containing the following information:
                    ``(A) Data on mergers, acquisitions, and changes in 
                ownership with respect to such specified entity for the 
                previous 1-year period.
                    ``(B) In the case that a specified entity is, or 
                includes, a hospital, the additional information 
                described in subsection (b).
                    ``(C) As applicable, the name, address, and 
                business structure of the parent company of such 
                specified entity (including the tax status of such 
                parent company), as of the date of the submission of 
                this report.
                    ``(D) Any other information with respect to 
                ownership of a specified entity, as determined by the 
                Secretary.
            ``(2) Subsequent reports.--Not later than 1 year after 
        submitting the report under paragraph (1), and annually 
        thereafter, each specified entity shall submit to the Secretary 
        an updated report, including--
                    ``(A)(i) data on mergers, acquisitions, and changes 
                in ownership with respect to such entities for the 
                previous 1-year period; and
                    ``(ii) any other information with respect to 
                ownership of a specified entity, as determined by the 
                Secretary; and
                    ``(B) in the case that a specified entity is, or 
                includes, a hospital, the additional information 
                described in subsection (b).
    ``(b) Additional Information Submitted by Certain Specified 
Entities.--For purposes of paragraphs (1)(B) and (2)(B) of subsection 
(a), with respect to a specified entity that is, or includes, a 
hospital, the information described in this subsection is the following 
information with respect to the previous 1-year period:
            ``(1) The business structure of the specified entity, 
        including the business type and the tax status of such entity.
            ``(2) The average debt-to-earnings ratio of the specified 
        entity.
            ``(3) The average amount of debt incurred--
                    ``(A) by the hospital; and
                    ``(B) by the entire specified entity.
            ``(4) Information with respect to real estate leases and 
        purchases for property used, or intended to be used, to furnish 
        or otherwise support the provision of health care services.
            ``(5) In the case of a non-profit hospital, a subsidiary of 
        a non-profit hospital, or a 501(c)(3) entity that shares common 
        ownership with a non-profit hospital, capital gains investments 
        (disaggregated by the type of investment) and any taxes paid on 
        such gains from such investments.
            ``(6) As applicable, information with respect to the parent 
        company of such specified entity.
    ``(c) Public Reporting.--Not later than January 1, 2027, and 
annually thereafter, the Secretary shall post on a publicly available 
website of the Department of Health and Human Services a report with 
respect to the previous 1-year period, including--
            ``(1) the number of specified entities reporting for such 
        year, disaggregated by the business structure of each specified 
        entity;
            ``(2) the number of owners of each specified entity;
            ``(3) any change in ownership for each specified entity;
            ``(4) any change in the tax status of a specified entity;
            ``(5) an analysis of trends in horizontal and vertical 
        consolidation, disaggregated by business structure and provider 
        type; and
            ``(6) as applicable, the name, address, and business 
        structure of the parent company of such specified entity 
        (including the business type and the tax status of such parent 
        company).
    ``(d) Audits.--The Secretary shall conduct an annual audit 
consisting of a random sample of specified entities to verify 
compliance with the requirements of this section and the accuracy of 
information submitted pursuant to this section.
    ``(e) Penalty for Failure To Report.--If a specified entity fails 
to provide a complete report under subsection (a), or submits a report 
containing false information, such entity shall be subject to a civil 
monetary penalty of not more than $5,000,000 for each such report not 
provided or containing false information. Such penalty shall be imposed 
and collected in the same manner as civil money penalties under 
subsection (a) of section 1128A are imposed and collected under that 
section.
    ``(f) Inapplicability of Paperwork Reduction Act.--Chapter 35 of 
title 44, United States Code, shall not apply to collections of 
information made under this section.
    ``(g) Definitions.--In this section:
            ``(1) Health plan.--The term `health plan' has the meaning 
        given such term in section 1128C(c).
            ``(2) Hospital.--The term `hospital' has the meaning given 
        such term in section 1861(e).
            ``(3) Independent freestanding emergency department.--The 
        term `independent freestanding emergency department' has the 
        meaning given such term in section 2799A-1(a)(3)(D) of the 
        Public Health Service Act.
            ``(4) Private equity company.--The term `private equity 
        company' means a publicly traded or non-publicly traded company 
        that collects capital investments from individuals or entities 
        and purchases an ownership share of a provider of services (as 
        defined in section 1861(u)).
            ``(5) Specified entity.--The term `specified entity' 
        means--
                    ``(A) a hospital;
                    ``(B) a physician-owned physician practice with 
                more than 25 physicians for a year;
                    ``(C) a physician practice owned by a hospital, a 
                health plan, a private equity company, or a venture 
                capital firm;
                    ``(D) an ambulatory surgical center meeting the 
                standards specified under section 1832(a)(2)(F)(i); or
                    ``(E) an independent freestanding emergency 
                department.
            ``(6) Venture capital fund.--The term `venture capital 
        fund' has the meaning given such term in section 275.203(l)-1of 
        title 17, Code of Federal Regulations.''.
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