State-Level Price Transparency Legislation
Last updated 7/24
Over the past decade, states have written numerous bills attempting to protect patients from rising healthcare costs. Once the Hospital Final Rule and The No Surprises Act (NSA) were passed, price transparency and patient estimates became federal requirements.
In addition to those federal requirements, some states have introduced or passed laws meant to work alongside or on top of federal Final Rules and laws. The table below tracks the various state bills and laws. Note that the table excludes the following:
- Any legislation written exclusively about drugs and/or pharmacy price transparency
- Any legislation written and/or passed prior to 1/1/2021, since the federal requirements became the overarching baseline for compliance
State By State
| State | Legislation? | Current Status | Summary |
| Alabama | No | ||
| Alaska | No | ||
| Arizona | Yes | SB 1603 Passed | Requires AZ Dept of Health to verify AZ hospitals are compliant with federal regulations and post their findings on a public website |
| Arkansas | Yes | HB 1452 Passed | If a hospital is not complaint with federal Final Rules, hospital will be fined $250 per day |
| California | No | ||
| Colorado | Yes | HB 22-1285 Passed | If a hospital is not complaint with federal Final Rules, hospital may not pursue a patient for collections |
| Colorado | Yes | SB 23-252 Passed | By 10/1/23, hospitals must post Medicare reimbursement rates in additional to federal price transparency requirements; hospital may not pursue a patient for collections and may be forced to refund any payments for noncompliance; state will maintain a name and shame list (updated annually) for noncompliance and will audit and assist hospitals to become compliant |
| Colorado | Yes | HB 23-1215 Passed | Prohibits billing patients facility fees on preventative care provided at a facility without an ED; adds facility fees to patient estimates; establishes a committee to track and report on facility fees in 2024. |
| Connecticut | Yes | SB 1203 Introduced | If a hospital is not complaint with federal Final Rules, hospital may not pursue a patient for collections |
| Delaware | No | ||
| Florida | Yes | HB 7089 Passed | Pulls requirements from the No Surprises Act and makes them state specific, with increased fines for noncompliance. |
| Florida | Yes | SB 268 Died | If a hospital is not compliant with federal Final Rules, hospital may not pursue a patient for collections |
| Georgia | No | ||
| Hawaii | No | ||
| Idaho | No | ||
| Illinois | Yes | HB 2609 Introduced | If a hospital is not complaint with federal Final Rules, hospital may be fined |
| Indiana | Yes | HB 1472 Introduced | Establishes an all-payer reimbursement model |
| Indiana | Yes | HB 249 Introduced | Builds on IN-specific GFE requirements and stipulates a process for reporting if insurance premiums increase > 5% over one calendar year |
| Indiana | Yes | HB 1447 Passed | IN-specific GFE requirements, and if a hospital is not compliant, may be fined no more than $1,000 per day |
| Indiana | Yes | S.4414 Introduced | Name and shame hospital noncompliance list |
| Indiana | Yes | HB 1004 Passed | Establishes a healthcare cost oversight task force; creates tax credits for PCPs in a physician-owned medical practice; establishes reporting by the Office of the Secretary and hospitals so the new task force can monitor costs and trends within Indiana healthcare |
| Iowa | No | ||
| Kansas | Yes | HB 2825 Introduced | Requires hopsitals to post 300 shoppable services and create estimates for elective procedures; noncompliance results in fines, hospitals being unable to pursue patient collections, and/or refund payers |
| Kentucky | Yes | HB145 Died | If a hospital is not complaint with federal Final Rules, hospital may not pursue a patient for collections |
| Louisiana | Yes | HB 427 Failed | If a hospital is not complaint with federal Final Rules, hospital may not pursue a patient for collections and may be fined |
| Maine | Yes | LD953 Passed | If a hospital is not complaint with federal Final Rules, hospital may not pursue a patient for collections |
| Maryland | No | ||
| Massachusetts | Yes | S.789 Died (got absorbed and removed from a larger HB) | Partially a repeat of the federal Final Rules but also has an elective procedure estimates requirement. VIolations are deemed an unfair and deceptive act. |
| Michigan | Yes | SB 447 Passed | Requires insurers to provide utilization and cost info as requested to large employer groups |
| Minnesota | Yes | S 62J.823 Passed | Requires providers to create and share simplified AEOBs and GFEs |
| Minnesota | Yes | SF 2995 Passed | Extends price transparency requirements to an extensive list of medical and dental providers with compliance dates starting 1/1/24, depending on provider type |
| Mississippi | No | ||
| Missouri | Yes | HB 1837 Introduced | If a hospital is not complaint with federal Final Rules, hospital may not pursue a patient for collections. Also patients can ask for a refund if the amount they got billed exceeds the charges reported in the MRF. |
| Montana | Yes | SB 364 Died | Caps hospital charges (not expected reimbursement) at 250% of the Medicare allowable Noncompliance may result in hospital paying patient the difference between what was on the bill and the Medicare rate |
| Nebraska | No | ||
| Nevada | No | ||
| New Hampshire | Yes | HB 389 Killed | If a hospital is not complaint with federal Final Rules, hospital may not pursue a patient for collections |
| New Jersey | Yes | S4254 Introduced | Virtually a carbon copy of the federal Final Rules, including fines |
| New Mexico | No | ||
| New York | Yes | A05307 Killed | Creates an office of healthcare accountability to provide recommendations regarding healthcare and hospital costs |
| North Carolina | Yes | SB 46 Passed | Prohibits Surprise Billing alongside NSA |
| North Dakota | No | ||
| Ohio | Yes | HB 49 Passed | If a hospital is not complaint with federal Final Rules, hospital may not pursue a patient for collections, may be fined, and may have to pay the patient 2x the debt amount. Hospitals must also post all shoppable services, not just 300, on 1/1/25. |
| Oklahoma | Yes | HB 1890 Introduced | OK-specific common shoppable services requirements, and if a hospital is not compliant, hospital may not pursue a patient for collections |
| Oklahoma | Yes | HB 4148 Passed | Codified into a previous law that hospitals who do not follow federal PT guidelines cannot collect medical debt from patients |
| Oklahoma | Yes | SB 732 Introduced | Senate bill that re-states if a hospital is not complaint with federal Final Rules, hospital may not send patient to collections. |
| Oregon | No | ||
| Pennsylvania | Yes | SB 83 Introduced | Follows federal MRF requirements and add additional requirements around other non-PT items (acquisitions, finances, etc.) |
| Pennsylvania | Yes | HB 864 Introduced | HB that mirrors SB 83 |
| Rhode Island | Yes | S2078 Passed | Virtually a carbon copy of the federal Final Rules, including fines |
| South Carolina | No | ||
| South Dakota | No | ||
| Tennessee | No | ||
| Texas | Yes | SB 490 Passed | Upon request, a provider must send an itemized bill, including info from payments a third party insurer made, to a patient within 30 days of the request. A provider may not pursue debt collection if the bill is not sent. |
| Texas | Yes | SB 1137 Passed | If a hospital is not complaint with federal Final Rules, hospital may be fined |
| Texas | Yes | SB 3218 Failed | TX-specific GFE requirements, and if a hospital is not compliant, hospital may not pursue a patient for collections |
| Utah | No | ||
| Vermont | No | ||
| Virginia | Yes | HB 2427 Failed | If a hospital is not complaint with federal Final Rules, hospital may not send patient to collections, or, if patient has already paid, hospital may have to refund patient up to 3x the amount |
| Virginia | Yes | Statute 32.1-137.05 Passed | VA-specific GFE requirements |
| Washington | Yes | HB 1508 Passed | Establishes a committee to monitor and ultimately lower the cost of healthcare in WA; committee is allowed to fine payers and providers for “practices causing excessive cost growth” |
| West Virginia | No | ||
| Wisconsin | Yes | LRB 2922 Failed | Requires the 300 shoppable services to be posted, regardless of a patient estimate tool; allows the state to fine hospitals for noncompliance |
| Wyoming | No |