On the Hill: Lawmakers Eye Surprise Billing and Price Transparency Fixes

Lawmakers are running short on time to advance health care priorities, with only a handful of legislative days remaining this year and, for some, in their congressional careers. Should Republicans lose control of one or both chambers of Congress, there would likely be an urgency to move quickly to enact key partisan priorities before their governing trifecta comes to an end.

Surprise Billing

The House Ways and Means Committee is developing legislation to overhaul the federal law that protects patients from surprise medical bills, according to people familiar with the discussions. The proposal could receive a committee markup as early as September, though its timeline remains uncertain given the limited number of legislative days remaining and the complexity of the ongoing negotiations. Congress enacted a bipartisan law in 2020 aimed at shielding patients from unexpected medical bills when they receive care at an in-network hospital but are treated by an out-of-network provider.

The law has since faced persistent implementation challenges. The independent dispute resolution process, established to determine payments between insurers and providers after patients are removed from billing disputes, has produced what critics describe as highly inflated reimbursement awards, raising concerns about higher health care costs. The new proposal would aim to address several of those issues. It would combine legislation from Rep. Greg Murphy (R-N.C.) that imposes penalties on insurers that miss payment deadlines with provisions designed to curb ineligible provider claims.

Ways and Means is unlikely to be the only committee weighing in on the issue. The Senate HELP Committee is expected to hold a member roundtable on surprise billing this fall. Chair Bill Cassidy (R-La.) said lawmakers from both parties are collaborating on efforts to "prevent ineligible claims while also ensuring timely physician payment."

Price Transparency

Republicans have identified price transparency as one of their top health care priorities this year as they head into a challenging midterm election cycle in which affordability remains a major voter concern. While the House passed bipartisan transparency legislation in 2023, the effort stalled before reaching the Senate.

With health care costs increasingly dominating campaign discussions, lawmakers in both chambers have renewed their focus on the issue. Multiple congressional committees have advanced legislation aimed at strengthening transparency requirements for hospitals and insurers.

Senate HELP Committee Chair Bill Cassidy (R-La.) recently suggested the momentum could carry transparency legislation into an end-of-year package, telling reporters, "I think the moment has come." In the Senate, a bipartisan bill (S. 2355, Patients Deserve Price Tags Act) requiring hospitals to publicly disclose cash prices and negotiated rates has advanced out of committee. The legislation would also impose potentially steep financial penalties on hospitals that fail to comply with the requirements.

The House Ways and Means Committee and the Energy and Commerce Committee have also moved hospital transparency measures this year. The Energy and Commerce proposal (H.R. 9393, The Lower Costs More Transparency Act of 2026) drew overwhelming bipartisan support. During the committee's markup, Energy and Commerce Chair Brett Guthrie (R-Ky.) described the package as the result of months of hearings and stakeholder discussions involving insurers, hospitals, and participants across the pharmaceutical supply chain.

Both the House and Senate are in recess.

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