[Congressional Record Volume 167, Number 41 (Thursday, March 4, 2021)]
[Senate]
[Page S1211]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]

  SA 981. Mr. BRAUN submitted an amendment intended to be proposed to 
amendment SA 891 proposed by Mr. Schumer to the bill H.R. 1319, to 
provide for reconciliation pursuant to title II of S. Con. Res. 5; 
which was ordered to lie on the table; as follows:

       At the end of section 2801 of the amendment, add the 
     following:
       (c) Transparency in Coverage.--
       (1) In general.--Section 1311(e)(3) of the Patient 
     Protection and Affordable Care Act (42 U.S.C. 18031(e)(3)) is 
     amended--
       (A) in subparagraph (A)--
       (i) in clause (vii), by inserting before the period the 
     following: ``, including, for all items and services covered 
     under the plan, aggregate information on specific payments 
     the plan has made to out-of-network health care providers on 
     behalf of plan enrollees''; and
       (ii) by designating clause (ix) as clause (x); and
       (iii) by inserting after clause (viii), the following:
       ``(ix) Information on the specific negotiated payment rates 
     between the plan and health care providers for all items and 
     services covered under the plan.'';
       (B) in subparagraph (B)--
       (i) in the heading, by striking ``use'' and inserting 
     ``delivery methods and use'';
       (ii) by inserting ``, as applicable,'' after ``English 
     proficiency''; and
       (iii) by inserting after the second sentence, the 
     following: ``The Secretary shall establish standards for 
     electronic delivery and access to such information by 
     individuals, free of charge, in machine readable format, 
     through an internet website and via open APIs.'';
       (C) in subparagraph (C)--
       (i) in the first sentence, by inserting ``or out-of-network 
     provider'' after ``item or service by a participating 
     provider'';
       (ii) in the second sentence, by striking ``through an 
     internet website'' and inserting ``free of charge, in machine 
     readable format, through an internet website, and via open 
     APIs, in accordance with standards established by the 
     Secretary,''; and
       (iii) by adding at the end the following: ``Such 
     information shall include specific negotiated rates that 
     allow for comparison between providers and across plans, and 
     related to a patient's specific plan, including after an 
     enrollee has exceeded their deductible responsibility.''; and
       (D) in subparagraph (D) by striking ``subparagraph (A)'' 
     and inserting ``subparagraphs (A), (B), and (C)''.
       (2) Enforcement.--In addition to any other enforcement 
     actions or penalties that may apply with respect to the 
     amendments made by paragraph (1), a hospital that fails to 
     provide the information required under such amendments shall 
     be subject to a civil monetary penalty of an amount not to 
     exceed $1000 per person per day that the violation is ongoing 
     as determined by the Secretary. Such penalty shall be imposed 
     and collected in the same manner as civil money penalties 
     under subsection (a) of section 1128A of the Social Security 
     Act are imposed and collected.
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