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Bipartisan Health Care Bills Spearheaded by North Carolina, Virginia Members of Congress

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WASHINGTON — Top lawmakers on the U.S. House Education and Workforce Committee Tuesday unveiled a bipartisan healthcare legislative package that would require accurate billing practices by hospitals, price transparency, and hidden fee disclosures.

Education and Workforce Committee Chair Virginia Foxx said the four bipartisan bills will help increase transparency for patients.

“The Committee is rectifying these issues by marking up four bipartisan bills designed to increase transparency, promote accurate billing practices, and expand health care options for workers and their families,” the North Carolina Republican said in a statement. “By putting forth legislative measures that codify transparent practices, we are delivering lower costs and more options to the American people.”

The bill, H.R. 4509, is known as the Transparency in Billing Act and is backed by Foxx with the top Democrat on the committee, Rep. Bobby Scott of Virginia. It would “require group health plans and health insurance issuers offering group health insurance coverage to only pay claims submitted by hospitals that have in place policies and procedures to ensure accurate billing practices and for other purposes.”

“Transparency in health care is essential for fostering meaningful competition, which keeps costs in check for both consumers and employers,” Scott said in a statement.

If signed into law, that bill would go into effect in January of next year.

Another bill in the package, H.R. 4507, written by Republican Rep. Bob Good of Virginia and Democratic Rep. Mark DeSaulnier of California, would “promote transparency in health coverage and reform pharmacy benefit management services with respect to group health plans.”

Good and DeSaulnier are the top lawmakers on the Health, Employment, Labor, and Pensions Subcommittee.

The price transparency for a group health plan and a health insurance issuer offering group health insurance would include disclosures of claims payment policies and practices, periodic financial disclosure, information on cost-sharing and payments with respect to any out-of-network coverage, and data on enrollment, disenrollment, rating practices and the number of ​​claims that are denied, among other requirements.

The third bill was introduced by Republican Rep. Lori Chavez-DeRemer of Oregon and Democratic Reps. Mark Takano of California and Kathy Manning of North Carolina.

That bill, the Health DATA Act, would ensure that fiduciaries “are not contractually restricted from receiving cost or quality of care information about their plan.”

A fiduciary is someone who runs a health insurance plan based solely on the interest of participants and beneficiaries.

The fourth bill, H.R. 4508, introduced by Democratic Rep. Joe Courtney of Connecticut and Republican Rep. Erin Houchin of Indiana, aims to strengthen compensation disclosure requirements for pharmacy benefit managers and third-party administrators to fiduciaries.

The committee will mark up all four bills on Wednesday at 10:15 a.m. Eastern.

by Ariana Figueroa, Virginia Mercury


Virginia Mercury is part of States Newsroom, a network of news bureaus supported by grants and a coalition of donors as a 501c(3) public charity. Virginia Mercury maintains editorial independence. Contact Editor Sarah Vogelsong for questions: info@virginiamercury.com. Follow Virginia Mercury on Facebook and Twitter.

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