H.R. 9393: Lower Costs, More Transparency Act of 2026

This bill would expand and standardize health care price transparency requirements for hospitals, laboratories, imaging providers, ambulatory surgical centers, and health plans.

Provider price posting

Beginning January 1, 2028, hospitals and certain other providers would have to publicly post pricing information in a standardized, machine-readable format. This would include:

• Gross charges
• Discounted cash prices
• Negotiated rates
• Prices for shoppable services

These providers would also need to update the information regularly, make it available for public access, and attest that the data is accurate. The bill would require the Department of Health and Human Services (HHS) to establish the required formats and monitor compliance.

Health plan disclosures

The bill would also require health plans to provide more detailed information about what services cost and how payments are structured. This includes:

• Cost-sharing information
• Negotiated rates
• Amounts paid for services
• Public machine-readable files
• Annual compliance attestations
• Accessibility accommodations for people who need them

It would also require disclosures related to pharmacy benefit managers (PBMs), including information about spread pricing. The bill would extend and replace existing price-comparison tools with these broader disclosure requirements. Most of these provisions would start on January 1, 2028.

Enforcement

HHS would be responsible for setting the reporting standards, checking compliance, and enforcing the rules. The bill would allow civil penalties that increase for repeated violations. It would also require ongoing compliance reporting so the government can track whether hospitals and plans are meeting the requirements.

Studies and reports

The bill would direct HHS and other entities to study the use of price-transparency application programming interfaces (APIs) and provider tools. These studies would look at issues such as:

• Whether the tools are practical to use
• Privacy concerns
• Costs of compliance
• How well enforcement works
• Effects on patients, providers, premiums, health care spending, and access to care

It would also require reports on compliance, differences in negotiated prices, and the availability of quality data. Current transparency rules would remain in place through 2027 while the new requirements are being prepared.

Relevant Companies

• HCA — Large hospital operator that would likely need to expand and update pricing disclosures across its facilities.
• CVS — Through its health insurance and pharmacy benefit management businesses, it could be affected by new disclosure requirements related to plan pricing and PBM spread pricing.
• UNH — Health insurer and benefits manager that would likely face new requirements to disclose cost-sharing, negotiated rates, and payment information.
• HUM — Health insurer that would likely need to provide additional public pricing and cost-sharing disclosures.
• CNC — Health insurer that would likely be subject to the new transparency and reporting requirements.
• CI — Health insurer and services company that could be directly affected by expanded disclosure and reporting obligations.
• CNC — Health plan operator that would likely face added obligations to publish standardized pricing data.