Hospital pricing transparency.

25LSO-0356
2025
STATE OF WYOMING
25LSO-0356
ENGROSSED
3.0

HOUSE BILL NO. HB0121

Hospital pricing transparency.

Sponsored by: Representative(s) Singh, Andrew, Bear, Haroldson, Harshman, Locke, Neiman and Rodriguez-Williams and Senator(s) Biteman, Hutchings, Laursen, D, Rothfuss and Salazar

A BILL

for

AN ACT relating to public health and safety; requiring hospitals to list prices for medical items and services as specified; requiring the department of health to monitor and enforce the provisions of this act; providing penalties; prohibiting collection actions as specified; requiring recommendations for proposed legislation; providing definitions; requiring rulemaking; making conforming amendments; and providing for effective dates.

Be It Enacted by the Legislature of the State of Wyoming:

Section 1
.

W.S. 35
‑
2
‑
1501 through 35
‑
2
‑
1511 are created to read:

ARTICLE 15
DISCLOSURE OF HOSPITAL PRICING

35
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2
‑
1501.

Short title; purpose.

(a)

This act shall be known and may be cited as the "Hospital Price Transparency Act."

(b)

The purpose of this act is to require hospitals to disclose prices for certain items and services, to provide civil penalties and to prohibit debt collection by noncompliant facilities.

35
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2
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1502.

Definitions.

(a)

As used in this act:

(i)

"Ancillary service" means a facility item or service that a facility customarily provides as part of a shoppable service;

(ii)

"Department" means the department of health;

(iii)

"De
‑
identified maximum negotiated charge" means the highest charge a facility has negotiated with all third party payors for a facility item or service;

(iv)

"De
‑
identified minimum negotiated charge" means the lowest charge a facility has negotiated with all third party payors for a facility item or service;

(v)

"Discounted cash price" means the charge that applies to a person who pays cash, or a cash equivalent, for a facility item or service;

(vi)

"Facility" means a hospital licensed under title 35 of the Wyoming statutes;

(vii)

"Facility item or service" means all items and services, including individual items and services and service packages, that may be provided by a facility to a patient in connection with an inpatient admission or an outpatient department visit for which the facility has established a standard charge, including:

(A)

Supplies and procedures;

(B)

Room and board;

(C)

Use of the facility and other areas, generally referred to as facility fees;

(D)

Services of health care providers employed by the facility, generally referred to as professional charges;

(E)

Any other item or service for which a facility has established a standard charge.

(viii)

"Gross charge" means the charge for a facility item or service that is reflected on a facility's list, less any discounts;

(ix)

"Machine
‑
readable format" means a digital representation of information that can be imported or read into a computer system for processing;

(x)

"Payor
‑
specific negotiated charge" means the charge that a facility has negotiated with a third party payor for a facility item or service;

(xi)

"Shoppable service" means a service that may be scheduled by a patient in advance;

(xii)

"Standard charge" means the regular rate established by the facility for a facility item or service provided to a specific group of paying patients. The term includes all of the following:

(A)

The gross charge;

(B)

The payor
‑
specific negotiated charge;

(C)

The de
‑
identified minimum negotiated charge;

(D)

The de
‑
identified maximum negotiated charge;

(E)

The discounted cash price.

(xiii)

"Third
‑
party payor" means a person that is, by statute, contract or agreement, legally responsible for payment of a claim for a facility item or service;

(xiv)

"This act" means W.S. 35
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2
‑
1501 through 35
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2
‑
1511.

35
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2
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1503.

Public availability of price information; requirements.

(a)

Notwithstanding any other law, a facility shall make public:

(i)

A digital file in a machine
‑
readable format that contains a list of all standard charges, expressed in dollar amounts, for all facility items or services as described by W.S. 35
‑
2
‑
1504;

(ii)

A consumer
‑
friendly list of standard charges for a limited set of shoppable services as provided in W.S. 35
‑
2
‑
1505.

35
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2
‑
1504.

List of standard charges required.

(a)

A facility shall:

(i)

Maintain a list of all standard charges for all facility items or services in accordance with this section; and

(ii)

Make the list required under paragraph (i) of this subsection available at all times to the public, including by posting the list in the manner provided by this section.

(b)

The standard charges contained in the list required to be maintained by a facility under subsection (a) of this section shall reflect the standard charges applicable to that location of the facility, regardless of whether the facility operates in more than one (1) location or operates under the same license as another facility.

(c)

The list required under subsection (a) of this section shall include the following items, if applicable:

(i)

A description of each facility item or service provided by the facility;

(ii)

The following charges, expressed in dollar amounts, for each individual facility item or service when provided in either an inpatient setting or an outpatient department setting:

(A)

The gross charge;

(B)

The de
‑
identified minimum negotiated charge;

(C)

The de
‑
identified maximum negotiated charge;

(D)

The discounted cash price;

(E)

The payor
‑
specific negotiated charge, listed by the name of the third party payor and plan associated with the charge and displayed in a manner that clearly associates the charge with each third party payor and plan; and

(F)

Any code used by the facility for purposes of accounting or billing for the facility item or service.

(d)

The list required by subsection (a) of this section shall be displayed in a prominent location on the home page of the facility's publicly accessible website or accessible through a link on that website. If the facility operates multiple locations and maintains a single website, the list shall be posted for each location the facility operates in a manner that clearly associates the list with the applicable location of the facility.

(e)

The list required under subsection (a) of this subsection shall:

(i)

Be available:

(A)

Free of charge;

(B)

Without having to establish a user account or password;

(C)

Without having to submit personal identifying information;

(D)

Without having to enter a code to access the list.

(ii)

Be accessible to a common commercial operator of an internet search engine to the extent necessary for the search engine to index and display the list as a result in response to a search query of a user of the search engine;

(iii)

Be formatted in a manner prescribed by the department;

(iv)

Be digitally searchable;

(v)

Use the naming convention specified by the centers for Medicare and Medicaid services.

(f)

In prescribing the format for the list under paragraph (e)(iii) of this section, the department shall:

(i)

Develop a template that each facility shall use in formatting the list;

(ii)

Consider any applicable federal guidelines for formatting similar lists required by federal law or rule and ensure that the design of the template enables health care researchers to compare the charges contained in the lists maintained by each facility; and

(iii)

Design the template to be substantially similar to the template used by the centers for Medicare and Medicaid services for purposes similar to those of this act, if the department determines that designing the template in that manner serves the purposes of paragraph (ii) of this subsection and that the department benefits from developing and requiring that substantially similar design.

(g)

Each facility shall update the list required by subsection (a) of this section not less than annually. Each facility shall clearly indicate the date on which the list was updated.

35
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2
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1505.

Consumer
‑
friendly list of shoppable services; requirements.

(a)

A facility shall maintain and make publicly available a list of the standard charges described by W.S. 35
‑
2
‑
1504(c) for not less than three hundred (300) shoppable services provided by the facility. Each facility may select the shoppable services to be included in the list, except that the list shall include:

(i)

The seventy (70) services specified by the centers for Medicare and Medicaid services in 45 C.F.R. part 180; or

(ii)

If the facility does not provide all of the shoppable services described by paragraph (i) of this subsection, as many of those shoppable services as the facility does provide. Services that are not provided but are Medicare and Medicaid listed services shall be identified by the facility; and

(iii)

State each location where a facility provides the shoppable service and whether the standard charges included in the list apply at that location to the provision of that shoppable service in an inpatient setting, an outpatient department setting or in both of those settings.

(b)

In selecting a shoppable service for purposes of inclusion in the list required by subsection (a) of this section, a facility shall:

(i)

Consider how frequently the facility provides the services and the facility's billing rate for that service; and

(ii)

Prioritize the selection of services that are among the services most frequently provided by the facility.

(c)

The list required by subsection (a) of this section shall be:

(i)

Displayed in a manner prescribed by W.S. 35
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2
‑
1504(d);

(ii)

Available:

(A)

Free of charge;

(B)

Without having to register or establish a user account or password;

(C)

Without having to submit personal identifying information; and

(D)

Without having to enter a code to access the list.

(iii)

Searchable by service description, billing code and third party payor;

(iv)

Updated in the manner prescribed by W.S. 35
‑
2
‑
1504(g);

(v)

Accessible to a common commercial operation of an internet search engine to the extent necessary for the search engine to index and display the list as a result in response to a search query of a user of the search engine; and

(vi)

Formatted in a manner that is consistent with the format prescribed by the department under W.S. 35
‑
2
‑
1504(e)(iii).

35
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2
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1506.

Reporting requirement.

Each time a facility updates a list as required by W.S. 35
‑
2
‑
1504(g) and 35
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2
‑
1505(c)(iv), the facility shall submit the updated list to the department. The department shall prescribe the form in which the updated list shall be submitted to the department.

35
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2
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1507.

Monitoring.

(a)

The department shall monitor each facility's compliance with the requirements of this act using any of the following methods:

(i)

Evaluating complaints made by persons to the department regarding noncompliance with the act;

(ii)

Reviewing any analysis prepared regarding noncompliance with this act;

(iii)

Auditing the websites of facilities for compliance with this act;

(iv)

Confirming that each facility submitted the lists as required by W.S. 35
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2
‑
1506.

(b)

Notwithstanding any provision of law to the contrary, in considering an application for renewal of a facility's license or certificate, the department shall consider whether a facility is or has been in compliance with this act.

35
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2
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1508.

Material violation; corrective action plan.

(a)

A facility materially violates this act if the facility fails to:

(i)

Comply with the requirements of W.S. 35
‑
2
‑
1503; or

(ii)

Publicize the facility's standard charges in the form and manner required by W.S. 35
‑
2
‑
1504 and 35
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2
‑
1505.

(b)

If the department determines that a facility has materially violated this act, the department shall issue a material violation notice to the facility and request that the facility submit a corrective action plan within thirty (30) days of receiving the material violation notice. The notice shall indicate the form and manner that the corrective action plan shall be submitted to the department and shall clearly state the date by which the facility shall submit the plan.

(c)

The facility that receives a notice under subsection (b) of this section shall:

(i)

Submit a corrective action plan in the form and manner, and by the specified date, prescribed by the notice of violation; and

(ii)

Act to comply with the plan within thirty (30) days of submitting the plan to the department.

(d)

A corrective action plan submitted to the department shall:

(i)

Describe in detail the corrective action the facility will take to address any violation identified by the department in the notice provided under subsection (b) of this section; and

(ii)

Provide a date by which the facility will complete the corrective action plan.

(e)

A corrective action plan is subject to review and approval by the department. After the department reviews and approves a facility's corrective action plan, the department shall monitor and evaluate the facility's compliance with the plan.

(f)

A facility is considered to have failed to respond to the department's request to submit a corrective action plan if the facility fails to submit a corrective action plan:

(i)

In the form and manner specified in the notice under subsection (b) of this section; or

(ii)

By the date specified in the notice provided in subsection (b) of this section.

(g)

A facility is considered to have failed to comply with a corrective action plan if the facility fails to address a violation within the specified period of time contained in the plan.

35
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2
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1509.

Civil penalty; notice of violations.

(a)

The department shall impose a civil penalty on a facility if a facility fails to:

(i)

Respond to the department's notice to submit a corrective action plan; or

(ii)

Comply with the requirements of a corrective action plan submitted to the department.

(b)

The department shall impose a civil penalty on a facility of:

(i)

For facilities categorized as critical access hospitals:

(A)

For a first offense, one hundred dollars ($100.00) per day for each day a facility fails to comply with subsection (a) of this section;

(B)

For a second offense, five hundred dollars ($500.00) per day for each day a facility fails to comply with subsection (a) of this section;

(C)

For a third or subsequent offense, one thousand dollars ($1,000.00) per day for each day a facility fails to comply with subsection (a) of this section.

(ii)

For all other facilities, one thousand dollars ($1,000.00) per day for each day a facility fails to comply with subsection (a) of this section.

(c)

Beginning October 1, 2025, the

department shall create and maintain a publicly available list on its website of facilities that have been found in violation of this act, that have been issued a civil penalty or sent a warning notice and that have been sent a request for a corrective action plan from the department. Such penalties, notices and communications shall be subject to public disclosure under 5 U.S.C. § 552, notwithstanding any exemptions or exclusions to the contrary, in full without redaction. The list required by this subsection shall be updated every thirty (30) days.

35
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2
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1510.

Legislative recommendations.

The department shall propose to the legislature any necessary recommendations for amending this act, including recommendations in response to amendments by the centers for Medicare and Medicaid services to 45 C.F.R. Part 180.

35
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2
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1511.

Prohibiting collective action of debt against patients by non
‑
compliant facilities.

(a)

As used in this section:

(i)

"Collection action" means any of the following actions taken with respect to a debt for items and services that were purchased from or provided to a patient by a facility on a date during which the facility was in material noncompliance with this act:

(A)

Attempting to collect a debt from a patient or patient guarantor by referring the debt, directly or indirectly, to a debt collector, a collection agency or a third party payor retained by or on behalf of the facility;

(B)

Suing the patient or patient guarantor, or enforcing an arbitration or mediation agreement; or

(C)

Directly or indirectly causing a report to be made to a consumer reporting agency.

(ii)

"Collection agency" means any:

(A)

Person who engages in a business the principal purpose of which is the collection of debts; or

(B)

Person who:

(I)

Regularly collects or attempts to collect, directly or indirectly, debts owed, due or asserted to be owed or due to another;

(II)

Takes assignment of debts for collection purposes; or

(III)

Directly or indirectly solicits for collection debts owed, due or asserted to be owed or due to another.

(iii)

"Consumer reporting agency" means any person who, for monetary fees, dues or on a cooperative nonprofit basis, regularly engages, in whole or in part, in the practice of assembling or evaluating consumer credit information or other information on consumers for the purpose of furnishing consumer reports to third parties. "Consumer reporting agency" includes any person defined in 15 U.S.C. § 1681a(f). "Consumer reporting agency" shall not include any business entity that provides check verification or check guarantee services only;

(iv)

"Debt" means any obligation or alleged obligation of a consumer to pay money arising out of a transaction, whether or not the obligation has been reduced to a judgment. "Debt" shall not include a debt for business, investment, commercial or agricultural purposes;

(v)

"Debt collector" means any person employed or engaged by a collection agency to perform the collection of debts owed, due or asserted to be owed or due to another.

(b)

A facility that is in material noncompliance with this act on the date that items and services are purchased from or provided to a patient by the facility shall not initiate or pursue a collection action against the patient or patient guarantor for a debt owed for the item or services.

(c)

If a patient provides documentation that a facility was in material noncompliance with this act on a date that items or services were purchased by or provided to the patient, and the facility takes collection action against the patient or patient guarantor, the patient or patient guarantor may file suit to determine if the facility was materially out of compliance with this act on the date of service, and the noncompliance is related to the items and services. The facility shall not take a collection action against the patient or patient guarantor while the lawsuit is pending.

(d)

A facility that has been found by a court of competent jurisdiction to be materially out of compliance with this act:

(i)

Shall refund the payor any amount of the debt the payor has paid and shall pay a penalty to the patient or patient guarantor in an amount equal to the total amount of the debt;

(ii)

Shall dismiss or cause to be dismissed any court action with prejudice and pay any attorney fees and costs incurred by the patient or patient guarantor relating to the action; and

(iii)

Remove or cause to be removed from the patient or patient guarantor's credit report any report made to a consumer reporting agency relating to the debt.

(e)

Nothing in this section:

(i)

Prohibits a facility from billing a patient, patient guarantor or third party payor for items or services provided to the patient; or

(ii)

Requires a facility to refund any payment made to the facility for items or services provided to the patient, provided no collection action is taken in violation of this section.

Section 2
.

W.S. 35‑2‑905(a) by creating a new paragraph (vi) is amended to read:

35
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2
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905.

Conditions, monitoring or revoking a license.

(a)

The division may place conditions upon a license, install a division approved monitor or manager at the owner's or operator's expense, suspend admissions, or deny, suspend or revoke a license issued under this act if a licensee:

(vi)

Violates any provision of W.S. 35
‑
2
‑
1501 through 35
‑
2
‑
1511.

Section 3.

The department of health shall promulgate all rules necessary to implement this act.

Section 4.

(a)

Except as otherwise provided by subsection (b) of this section, this act is effective July 1, 2025
.

(b)

Sections 3 and 4 of this act are effective immediately upon completion of all acts necessary for a bill to become law as provided by Article 4, Section 8 of the Wyoming Constitution.

(END)

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HB0121