Lower Costs, More Transparency Act of 2026

This bill requires hospitals, clinical diagnostic laboratories, imaging service providers, ambulatory surgical centers, and group health plans to make their prices public starting January 1, 2028, to promote price transparency in health care.

Sec. 2, Hospital price transparency: Starting January 1, 2028, each hospital that receives Medicare payments must publicly list all standard charges, prices for at least 300 shoppable services, and other information like gross charges, discounted cash prices, and payer-specific negotiated charges, all in a uniform format set by the Secretary of Health and Human Services.

Sec. 3, Clinical diagnostic laboratory test price transparency: Starting January 1, 2028, applicable laboratories that receive Medicare payments must publicly post the discounted cash price or gross charge for each clinical diagnostic laboratory test they furnish, update it annually, and include an attestation of accuracy. Noncompliance can lead to civil monetary penalties of up to $300 per day.

Sec. 4, Imaging price transparency: Starting January 1, 2028, providers and suppliers that receive Medicare payments for specified imaging services must publicly post the discounted cash price or gross charge for each service, update it annually, and include an attestation of accuracy. Noncompliance can lead to civil monetary penalties of up to $300 per day, with possible waiver or reduction to protect access to care.

Sec. 5, Ambulatory surgical center price transparency: Starting January 1, 2028, each ambulatory surgical center that receives Medicare payments must publicly list all standard charges and prices for at least 300 shoppable services, including gross charges and discounted cash prices, in a uniform format. The Secretary will monitor compliance.

Sec. 6, Health coverage price transparency: For plan years starting on or after January 1, 2028, group health plans must provide participants or beneficiaries, upon request, cost-sharing information for specific items or services, including in-network rates, estimated cost sharing, deductible accumulations, and prior authorization requirements, through a self-service tool or paper or phone disclosure at no cost.