House committee hears bill to require hospital price transparency; sponsors point to low federal compliance, hospitals push back

Representative Jared Hendricks opened the hearing on House Bill 1594, which would require health care facilities to make price and negotiated‑rate information publicly available in formats consistent with federal hospital price‑transparency rules and would create a state enforcement path and penalty for noncompliance.

The bill’s sponsor said transparent prices help consumers and can pressure costs down over time. "Prices themselves tend to incentivize more efficient usage of resources," Hendricks said, and he cited national analyses that show wide price variation for common procedures. He noted a patient‑advocacy analysis that found low federal compliance and told the committee that a state enforcement option would provide an additional compliance mechanism.

Why it matters: Witnesses said lack of accessible price information limits consumers’ ability to shop for nonemergency or elective services and contributes to rising health insurance premiums. Sponsor testimony cited a secret‑shopper comparison by the insurance department showing thousands‑of‑dollars differences for similar procedures at different facilities.

Supporters, technical testimony and federal rule background Chris Jones, senior fellow at the Cicero Institute, testified that most hospitals nationwide are not fully compliant with the Centers for Medicare & Medicaid Services rule on hospital price transparency (45 CFR chapter 180 as stated in testimony). He said states can adopt additional enforcement to implement the federal rule’s intent and argued the proposal is a first step toward letting consumers compare prices for shoppable services.

Insurance Commissioner John Godfrey told the committee the department’s 2019 health‑care cost study used a secret‑shopper approach and found wide price variation for common procedures. Godfrey said the state often defers to federal enforcement on CMS rules but that the secret‑shopper process was time‑consuming and difficult because facilities do not always provide the requested pricing data in a comparable way.

Hospitals and provider concerns The North Dakota Hospital Association opposed section 1 of the bill and asked that the bill not duplicate the federal framework that went into effect in 2021. Tim Blaso, association president, said hospitals are following CMS rules and that hospitals will provide price estimates on request. "If you call the hospital, they will give you a price quote on what you're having done," he told the committee, though he acknowledged the estimates are just that — estimates.

Other concerns during questioning included whether the bill would require state resources to monitor compliance, how penalties would scale for smaller facilities (the sponsor referenced a $1,000‑a‑day penalty in the draft), and the extent to which posted prices are actionable for insured patients given contract differences among payers.

Outcome and committee notes Committee members asked technical and policy questions about enforcement, the relationship to federal CMS rules, and the administrative burden on hospitals. The insurance commissioner and the insurance department staff signaled willingness to work with sponsors on implementation. The hearing concluded with no recorded committee vote.