For further information see the state fiscal estimate, which will be printed as an appendix to this bill.
SB328,,44The people of the state of Wisconsin, represented in senate and assembly, do enact as follows:
SB328,15Section 1. 50.40 of the statutes is created to read:
SB328,,6650.40 Hospital price transparency. (1) Definitions. In this section:
SB328,,77(a) “Ancillary service” means a hospital item or service that a hospital customarily provides as part of a shoppable service.
SB328,,88(b) “Chargemaster” means the list of all hospital items or services maintained by a hospital for which the hospital has established a charge.
SB328,,99(c) “De-identified maximum negotiated charge” means the highest charge that a hospital has negotiated with all 3rd-party payors for a hospital item or service.
SB328,,1010(d) “De-identified minimum negotiated charge” means the lowest charge that a hospital has negotiated with all 3rd-party payors for a hospital item or service.
SB328,,1111(e) “Discounted cash price” means the charge that applies to an individual who pays cash, or a cash equivalent, for a hospital item or service.
SB328,,1212(f) “Gross charge” means the charge for a hospital item or service that is reflected on a hospital’s chargemaster, absent any discounts.
SB328,,1313(g) “Hospital items or services” means all items and services, including individual items and services and service packages, that may be provided by a hospital to a patient in connection with an inpatient admission or an outpatient department visit for which the hospital has established a standard charge, including all of the following:
SB328,,14141. Supplies and procedures.
SB328,,15152. Room and board.
SB328,,16163. Use of the hospital and other areas.
SB328,,17174. Services of physicians and nonphysician practitioners employed by the hospital.
SB328,,18185. Any other item or service for which a hospital has established a standard charge.
SB328,,1919(h) “Machine-readable format” means a digital representation of information in a file that can be imported or read into a computer system for further processing. “Machine-readable format” includes .XML, .JSON, and .CSV formats.
SB328,,2020(i) “Payor-specific negotiated charge” means the charge that a hospital has negotiated with a 3rd-party payor for a hospital item or service.
SB328,,2121(j) “Service package” means an aggregation of individual hospital items or services into a single service with a single charge.
SB328,,2222(k) “Shoppable service” means a service that may be scheduled by a health care consumer in advance.
SB328,,2323(L) “Standard charge” means the regular rate established by the hospital for a hospital item or service provided to a specific group of paying patients and includes all of the following:
SB328,,24241. The gross charge.
SB328,,25252. The payor-specific negotiated charge.
SB328,,26263. The de-identified minimum negotiated charge.
SB328,,27274. The de-identified maximum negotiated charge.
SB328,,28285. The discounted cash price.
SB328,,2929(m) “Third-party payor” means an entity that is, by statute, contract, or agreement, legally responsible for payment of a claim for a hospital item or service.
SB328,,3030(2) Public availability of price information required. A hospital shall make publicly available all of the following: