Requires DOH to evaluate hospital compliance with federal hospital price transparency requirements.

S4026

SENATE, No. 4026

STATE OF NEW JERSEY

222nd LEGISLATURE

�

INTRODUCED MARCH 19, 2026

Sponsored by:

Senator� JOSEPH F. VITALE

District 19 (Middlesex)

SYNOPSIS

���� Requires DOH to evaluate hospital compliance with
federal hospital price transparency requirements.

CURRENT VERSION OF TEXT

���� As introduced.

��

An Act
concerning hospital pricing and supplementing Title 26
of the Revised Statutes.

����
Be It
Enacted
by the Senate and General Assembly of
the State of New Jersey:

����� 1.�� As
used in this act:

����� �Department�
means the New Jersey Department of Health

����� �Hospital�
means a hospital licensed pursuant to P.L.1971, c.136 (C.26:2H-1 et seq.) and
subject to the federal hospital price transparency requirements under 45 C.F.R.
Part 180.

����� �Standard
charge� means the same as that term is defined by the federal Centers for
Medicare and Medicaid Services at 45 C.F.R. 180.20 or any superseding
regulation.

����� 2.�� a.�
(1)� The Department of Health shall require each hospital in this State to be
in compliance with the federal hospital price transparency requirements under
45 C.F.R. Part 180, and shall evaluate whether each hospital has complied with
such requirements.

����� (2)�
The department may use methods to monitor and assess hospital compliance, which
may include, but may not be limited to:

����� (a)�
evaluation of complaints made by individuals or entities to the department;

����� (b)�
review of individuals' or entities' analysis of noncompliance; and

����� (c)�
audit of hospitals' websites.

����� b.�
If the department concludes that a hospital is noncompliant with one or more of
the federal hospital price transparency requirements under 45 C.F.R. Part 180,
the department may take any of the following actions:

����� (1)�
provide a written warning notice to a hospital of a specific violation;

����� (2)�
request a corrective action plan from the hospital if its noncompliance
constitutes a material violation of the requirements; or

����� (3)�
impose a civil monetary penalty on the hospital and publish the penalty on the
department�s Internet website if the hospital fails to respond to the
department�s request to submit a corrective action plan or comply with the
requirements of the corrective action plan.

����� c.�� Each
year, the department shall prepare and submit a report detailing hospitals�
compliance with the federal hospital price transparency requirements under 45
C.F.R. Part 180 and any other provisions of this act, and any other relevant
findings or recommendations to the Governor, and to the Legislature, pursuant
to section 2 of P.L.1991, c.164 (C.52:14-19.1).� The department shall publish
each report on its Internet website.

����� 3.�� a.�
The department shall determine if a hospital's noncompliance with the federal
hospital price transparency requirements under 45 C.F.R. Part 180 constitutes a
material violation requiring a corrective action plan.� A material violation
may include, but may not be limited to, a hospital's failure to publish its
standard charges in the form and manner as required pursuant to the federal
requirements under 45 C.F.R. 180.50.

����� b.�
The department may request that a hospital submit a corrective action plan,
specified in a notice of violation issued by the department to a hospital.

����� c.�
(1)� A hospital required to submit a corrective action plan shall do so, in the
form and manner, and by the deadline, specified in the notice of violation
issued by department to the hospital.

����� (2)�
A hospital's corrective action plan shall specify elements including, but not
limited to:

����� (a)�
the corrective actions or processes the hospital shall take to address the
deficiency identified by the department; and

����� (b)�
the timeframe by which the hospital shall complete the corrective action.

����� 4.�� a.�
The department may impose a civil monetary penalty on a hospital that violates
any federal requirement under 45 C.F.R. Part 180 or any other provision of this
act.

����� b.�
(1)� If the department imposes a penalty in accordance with this section, the
department shall provide a written notice of imposition of a civil monetary
penalty to the hospital via certified mail or another form of traceable
carrier.

����� (2)�
The notice to the hospital may include, but may not be limited to, the
following:

����� (a)�
The basis for the hospital's noncompliance, including, but not limited to, the
following:

����� (i)�
the department�s determination as to which requirement the hospital has
violated; and

����� (ii)�
the hospital's failure to respond to the department�s request to submit a
corrective action plan or comply with the requirements of a corrective action
plan.

����� (b)�
The department�s determination as to the effective date for the violation. This
date shall be the latest date of the following:

����� (i)�
the first day the hospital is required to meet the requirements of this
section;

����� (ii)�
if a hospital previously met the requirements of this section but did not
update the information annually as required, the date 12 months after the date
of the last annual update specified in information posted by the hospital; and

����� (iii)�
a date determined by the department, such as one resulting from monitoring
activities, or development of a corrective action plan.

����� (c)�
The amount of the penalty as of the date of the notice.

����� (d)�
A statement that a civil monetary penalty may continue to be imposed for a
continuing violation.

����� (e)�
Payment instructions.

����� (f)�
Intent to publish the hospital's noncompliance and the department�s
determination to impose a civil monetary penalty on the hospital for
noncompliance by posting the notice of imposition of a civil monetary penalty
on the department�s Internet website.

����� (g)�
A statement of the hospital's right to a hearing.

����� (h)�
A statement that the hospital's failure to request a hearing within 30 calendar
days of the issuance of the notice permits the imposition of the penalty, and
any subsequent penalties pursuant to continuing violations, without the right
of appeal.� If the civil monetary penalty is upheld, in part, by a final and
binding decision, the department shall issue a modified notice of imposition of
a civil monetary penalty to conform to the adjudicated finding.

����� c.�
(1)� The department shall determine the daily dollar amount for a civil
monetary penalty for which a hospital may be subject as follows:

����� (a)�
for each day a hospital is determined by the department to be out of
compliance:

����� (i)�
For a hospital with a number of beds equal to or less than 30, the maximum
daily dollar civil monetary penalty amount to which it may be subject shall be
$300, even if the hospital is in violation of multiple discrete requirements.

����� (ii)�
For a hospital with at least 31 and up to and including 550 beds, the maximum
daily dollar civil monetary penalty amount to which it may be subject shall be
the number of beds times $10, even if the hospital is in violation of multiple
discrete requirements.

����� (iii)�
For a hospital with a number of beds greater than 550, the maximum daily dollar
civil monetary penalty amount to which it may be subject shall be $5,500, even
if the hospital is in violation of multiple discrete requirements.

����� (iv)�
The department shall use the most recently available, finalized Medicare
hospital cost report to determine the number of beds for a Medicare-enrolled
hospital, for purposes of determining the maximum daily dollar civil monetary
penalty amount under this section.

����� (v)�
If the number of beds for the hospital cannot be determined, the department
shall request that the hospital provide documentation of its number of beds, in
a form and manner and by the deadline prescribed by the department in a written
notice provided to the hospital.� If the hospital fails to provide the
department with this documentation in the prescribed form and manner, and by
the specified deadline, the department shall impose on the hospital the maximum
daily dollar civil monetary penalty amount permissible under this section.

����� (vi)�
The amount of the civil monetary penalty shall be adjusted annually using the
multiplier determined by the federal government for annually adjusting civil
monetary penalty amounts under federal law.

����� (2)�
A hospital shall pay the civil monetary penalty in full within 60 calendar days
after the date of the notice of imposition of a civil monetary penalty from the
department.

����� (3)�
If a hospital requests a hearing, the hospital shall pay the amount in full
within 60 calendar days after the date of a final and binding decision to
uphold, in whole or in part, the civil monetary penalty.

����� (4)�
If the 60th calendar day is a weekend or a federal or State holiday, then the
timeframe shall be extended until the end of the next business day.

����� d.�
(1)� The department shall post the notice of imposition of a civil monetary
penalty on the department�s Internet website.

����� (2)�
If a hospital elects to request a hearing:

����� (a)�
the department shall indicate in its posting that the civil monetary penalty is
under review.

����� (b)�
If the civil monetary penalty is upheld, in whole, by a final and binding
decision, the department shall maintain the posting of the notice of imposition
of a civil monetary penalty on the department�s Internet website.

����� (c)�
If the civil monetary penalty is upheld, in part, by a final and binding
decision, the department shall issue a modified notice of imposition of a civil
monetary penalty to conform to the adjudicated finding.� The department shall
publish the modified notice on the department�s Internet website.

����� (d)�
If the civil monetary penalty is overturned in full by a final and binding
decision, the department shall remove the notice of imposition of a civil
monetary penalty from the department�s Internet website.

���� 5.��� A hospital upon which
the department has imposed a penalty may appeal that penalty.� In determining
whether the amount of a civil money penalty is reasonable, a court may consider
evidence of record relating to the following:� the hospital's posting of its
standard charges, if available, material the hospital previously submitted to
the department, including with respect to corrective actions and corrective
action plans, and material the department used to monitor and assess the
hospital's compliance.

���� 6.��� a. If a hospital does
not request a hearing within 30 calendar days of the issuance of a notice of
imposition of a civil monetary penalty, the department may impose the civil
monetary penalty indicated in such notice and may impose additional penalties pursuant
to continuing violations without the right of appeal.� If the 30th calendar day
is a weekend or a federal or State holiday, then the timeframe shall be
extended until the end of the next business day.

���� b. A hospital shall have no
right to appeal a penalty with respect to which it has not requested a hearing,
unless the hospital can show good cause for failing to timely exercise its
right to a hearing.

���� 7.��� The Commissioner of
Health shall adopt rules and regulations, in accordance with the
�Administrative Procedure Act,� P.L.1968, c.410 (C.52:14B-1 et seq.), as are
necessary to effectuate the provisions of this act.

���� 8.��� This act shall take
effect 180 days following enactment.

STATEMENT

����
This bill provides that the Department of Health
(department) is to require each hospital in this State to be in compliance with
federal hospital price transparency requirements under 45 C.F.R. Part 180 and
to evaluate whether each hospital has complied with such requirements.� If the
department concludes that a hospital is noncompliant with one or more of the
federal requirements, the department may take any of the following actions: (1)
provide a written warning notice to a hospital of a specific violation; (2)
request a corrective action plan from the hospital if its noncompliance
constitutes a material violation; or (3) impose a civil monetary penalty on the
hospital and publish the penalty on the department�s� website if the hospital
fails to respond to the department�s request to submit a corrective action plan
or comply with the requirements of the corrective action plan.� A material
violation may include a hospital's failure to publish its standard charges.� A
hospital's corrective action plan is to specify elements including: (1) the
corrective actions or processes the hospital is to take to address the
deficiency identified by the department; and (2) the timeframe by which the
hospital is to complete the corrective action.

����� The department may impose a civil monetary penalty on
a hospital that violates any of the federal hospital price transparency
requirements under 45 C.F.R. Part 180 or any of the bill�s provisions.� A
hospital is to pay the civil monetary penalty in full within 60 calendar days
after the date of the notice of imposition of a civil monetary penalty.

����� A hospital upon which the department has imposed a
penalty may appeal that penalty.� If a hospital does not request a hearing
within 30 calendar days of the issuance of a notice of imposition of a civil
monetary penalty, the department may impose the civil monetary penalty
indicated in such notice and may impose additional penalties in response to
continuing violations without the right of appeal.