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Trends in Price and Quality Transparency
All Payer Claims Databases (APCD)
For more on APCD’s, check out our Legislative Topics: All Payer Claims Databases overview on Medium.
Pharmaceutical Price Transparency Legislation
For more on this legislation, refer to our Issue Brief on The Source Blog and the NASHP Center for Rx Pricing.
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Key:
- Price Transparency Legislation
Recent Action in Price and Quality Transparency
HB 263 – Utah
Introduced: 2020 Status: Inactive / Dead
Notice of Drug Price Increase. This bill requires a prescription drug manufacturer to provide notice of certain drug cost increases and requires the Insurance Department to publish related information.
SB 155 – Utah
Introduced: 2020 Status: Enacted
This bill enacts provisions related to balance billing for certain health care services. This bill: requires health care facilities and health care providers who engage in balance billing for certain health care services to submit …
HB 456 – Utah
Introduced: 2020 Status: Inactive / Dead
This bill enacts provisions relating to balance billing for emergency services by a health care facility. Enacts procedures that managed care organizations and a health care facility must follow if there is a dispute regarding …
HB 457 – Utah
Introduced: 2020 Status: Inactive / Dead
This bill enacts requirements related to billing and provider networks for certain health insurance plans. This bill requires a managed care organization to provide adequate coverage of certain health care services in the managed care …
HB 379 – Utah
Introduced: 2020 Status: Inactive / Dead
This bill enacts requirements related to billing and provider networks for certain health insurance plans. This bill requires a managed care organization to provide adequate coverage of certain health care services in the managed care …
S 309 – Vermont
Introduced: 2020 Status: In Process
An act relating to limitations on health care contract provisions and surprise medical bills. This bill proposes to prohibit certain provisions in contracts between health insurers and health care providers. It would also limit patients’ …
H 825 – Vermont
Introduced: 2020 Status: In Process
An act relating to limitations on health care contract provisions and surprise medical bills. This bill proposes to prohibit certain provisions in contracts between health insurers and health care providers. It would also limit patients’ …
Next | See all Legislation Records
Introduced: 2020 Status: Inactive / Dead
Notice of Drug Price Increase. This bill requires a prescription drug manufacturer to provide notice of certain drug cost increases and requires the Insurance Department to publish related information.
SB 155 – Utah
Introduced: 2020 Status: Enacted
This bill enacts provisions related to balance billing for certain health care services. This bill: requires health care facilities and health care providers who engage in balance billing for certain health care services to submit …
HB 456 – Utah
Introduced: 2020 Status: Inactive / Dead
This bill enacts provisions relating to balance billing for emergency services by a health care facility. Enacts procedures that managed care organizations and a health care facility must follow if there is a dispute regarding …
HB 457 – Utah
Introduced: 2020 Status: Inactive / Dead
This bill enacts requirements related to billing and provider networks for certain health insurance plans. This bill requires a managed care organization to provide adequate coverage of certain health care services in the managed care …
HB 379 – Utah
Introduced: 2020 Status: Inactive / Dead
This bill enacts requirements related to billing and provider networks for certain health insurance plans. This bill requires a managed care organization to provide adequate coverage of certain health care services in the managed care …
S 309 – Vermont
Introduced: 2020 Status: In Process
An act relating to limitations on health care contract provisions and surprise medical bills. This bill proposes to prohibit certain provisions in contracts between health insurers and health care providers. It would also limit patients’ …
H 825 – Vermont
Introduced: 2020 Status: In Process
An act relating to limitations on health care contract provisions and surprise medical bills. This bill proposes to prohibit certain provisions in contracts between health insurers and health care providers. It would also limit patients’ …
Next | See all Legislation Records
Community Hospitals and Wellness Centers v. State of Ohio – Ohio
District Court: Common Pleas Court of Williams County Status: Decided
Ohio’s Healthcare Price Transparency Law, passed in June 2015 (HB 52) by the Ohio Legislature, has been challenged by health care providers arguing that the …
Pharmaceutical Care Management Association (PCMA) v. Mulready – Oklahoma
District Court: District Court of Western District of Oklahoma Status: Pending
The 2019 Oklahoma law, Patient’s Right to Pharmacy Choice Act, targets PBM conflict of interest by prohibiting higher reimbursement rates for PBM-owned pharmacies and bans …
PhRMA and BIO v. Sandoval – Nevada
District Court: District of Nevada Status: Decided
In September 2017, just three months after Nevada passed its insulin transparency law (SB 539) in June 2017 to increase transparency over the price of …
Pharmaceutical Care Management Association (PCMA) v. Rutledge – Arkansas
District Court: Eastern District of Arkansas Status: Pending
Act 900 (SB 688), enacted in 2015, required disclosure of generic drug pricing and sets a floor on prices that PBMs can pay to pharmacies …
PhRMA v. David – California
District Court: Eastern District of California Status: Pending
PhRMA is challenging California’s drug price transparency law SB 17 alleging that the law is unconstitutional because it violates the Commerce Clause, the First Amendment, …
Association for Accessible Medicines v. Frosh – Maryland
District Court: District of Maryland Status: Decided
In a significant victory for the pharmaceutical industry, the 4th U.S. Circuit Court of Appeals found Maryland’s landmark 2017 law (HB 631), which punishes generic …
See all Litigation Records
District Court: Common Pleas Court of Williams County Status: Decided
Ohio’s Healthcare Price Transparency Law, passed in June 2015 (HB 52) by the Ohio Legislature, has been challenged by health care providers arguing that the …
Pharmaceutical Care Management Association (PCMA) v. Mulready – Oklahoma
District Court: District Court of Western District of Oklahoma Status: Pending
The 2019 Oklahoma law, Patient’s Right to Pharmacy Choice Act, targets PBM conflict of interest by prohibiting higher reimbursement rates for PBM-owned pharmacies and bans …
PhRMA and BIO v. Sandoval – Nevada
District Court: District of Nevada Status: Decided
In September 2017, just three months after Nevada passed its insulin transparency law (SB 539) in June 2017 to increase transparency over the price of …
Pharmaceutical Care Management Association (PCMA) v. Rutledge – Arkansas
District Court: Eastern District of Arkansas Status: Pending
Act 900 (SB 688), enacted in 2015, required disclosure of generic drug pricing and sets a floor on prices that PBMs can pay to pharmacies …
PhRMA v. David – California
District Court: Eastern District of California Status: Pending
PhRMA is challenging California’s drug price transparency law SB 17 alleging that the law is unconstitutional because it violates the Commerce Clause, the First Amendment, …
Association for Accessible Medicines v. Frosh – Maryland
District Court: District of Maryland Status: Decided
In a significant victory for the pharmaceutical industry, the 4th U.S. Circuit Court of Appeals found Maryland’s landmark 2017 law (HB 631), which punishes generic …
See all Litigation Records
News & Opinions
Articles & Reports
Health Affairs
June 1, 2020
Health Affairs June 1, 2020
Catalyst for Payment Reform and The Source May 5, 2020
Georgetown Law Journal April 28, 2020
Health Affairs June 1, 2020
Catalyst for Payment Reform and The Source May 5, 2020
Georgetown Law Journal April 28, 2020
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