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![handle is hein.congrecreports/crptxagqr0001 and id is 1 raw text is: AUT-ENTICATED
US. GOVERNMENT
INFORMATION
GPO
118TH CONGRESS REPT. 118-742
2d Session HOUSE OF REPRESENTATIVES Part 1
TRANSPARENCY IN COVERAGE ACT
NOVEMBER 18, 2024.-Ordered to be printed
Ms. Foxx, from the Committee on Education and the Workforce,
submitted the following
REPORT
[To accompany H.R. 4507]
The Committee on Education and the Workforce, to whom was
referred the bill (H.R. 4507) to amend the Employee Retirement In-
come Security Act of 1974 to promote transparency in health cov-
erage and reform pharmacy benefit management services with re-
spect to group health plans, and for other purposes, having consid-
ered the same, reports favorably thereon with an amendment and
recommends that the bill as amended do pass.
The amendment is as follows:
Strike all after the enacting clause and insert the following:
SECTION 1. SHORT TITLE.
This Act may be cited as the Transparency in Coverage Act.
SEC. 2. PROMOTING GROUP HEALTH PLAN AND GROUP HEALTH INSURANCE COVERAGE
PRICE TRANSPARENCY.
(a) IN GENERAL.-
(1) ERISA.-
(A) IN GENERAL.-Section 719 of the Employee Retirement Income Secu-
rity Act of 1974 (29 U.S.C. 1185h) is amended to read as follows:
SEC. 719. PRICE TRANSPARENCY REQUIREMENTS.
(a) IN GENERAL.-A group health plan, and a health insurance issuer offering
group health insurance coverage, shall make available to the public accurate and
timely disclosures of the following information:
(1) Claims payment policies and practices.
(2) Periodic financial disclosures.
(3) Data on enrollment.
(4) Data on disenrollment.
(5) Data on the number of claims that are denied.
(6) Data on rating practices.
(7) Information on cost-sharing and payments with respect to any out-of-net-
work coverage (or with respect to any item and service furnished under such
a plan or such group health insurance coverage that does not use a network
of providers).
(8) Information on participant and beneficiary rights under this part.
(9) Rate and payment information described in subsection (d).
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