The House Education and Workforce Committee approved four HR Policy-supported bills that would increase hospital and PBM transparency. The bipartisan bills would require PBMs to disclose payments to insurers, ensure employers can audit and obtain their claims data from providers and third parties, and codify the Trump-era Transparency in Coverage rule.
The Transparency in Billing Act (H.R. 4509) was approved with a 39-0 vote and would require hospitals and their off-campus outpatient locations to provide unique health identifiers for the department where the item or service was provided to ensure claims are appropriately billed.
The Transparency in Coverage Act (H.R. 4507) was approved with a 38-1 vote and would require insurers to make public certain data, including claims payment policies and information on cost-sharing and payments for out-of-network coverage.
- It would also prohibit insurers or PBMs from entering into contracts with drug manufacturers if they cannot comply with the transparency requirements.
The Health DATA Act (H.R. 4527) was approved with a 38-1 vote and would ensure employers can access and audit de-identified health claims data to make sure compensation by the plan is reasonable.
The Hidden Fee Disclosure Act (H.R. 4508) was approved with a 38-1 vote and would strengthen the requirements that PBMs and Third-Party Administrators (TPAs) disclose certain compensation data to employers.
Rep. Eric Burlison (R-MO) was the lone no vote against three of the bills, arguing each would have downstream effects that would increase prices.
Separately, the House Energy and Commerce, Health Subcommittee, passed the HR Policy-supported Telehealth Benefit Expansion for Workers Act (H.R. 824), which would allow employers to permanently offer telehealth benefits as a standalone excepted benefit to part-time and seasonal employees who do not qualify for full health benefits.
Outlook: The broad bipartisan support for the bills greatly increases the likelihood the bills will be brought to the House floor for a vote later this year. At a time of intense partisan differences, Chair Virginia Foxx (R-NC) and Ranking Member Bobby Scott (D-VA) and their colleagues demonstrated welcome leadership in the very contentious area of federal health care policy.
