Great American Healthcare Act

Expanded Health Savings Account (HSA) Uses: The bill allows HSAs to cover "qualified wellness expenses" such as healthy food, vitamins, dietary supplements, and certain sports and fitness expenses (Section 108).

Increased HSA Contribution Limits: The legislation modifies the Internal Revenue Code to increase contribution limitations for HSAs (Section 102).

Enhanced Price Transparency: Hospitals, clinical diagnostic laboratories, imaging providers, and ambulatory surgical centers are required to make their standard charges and negotiated prices public (Sections 302, 303, 304, and 305).

Improved Health Plan Data Access: The bill requires group health plans to provide better access to claims and encounter data, which can help determine the accuracy of payments (Section s 307).

Bankruptcy Protections: Health savings accounts would receive the same bankruptcy protections as individual retirement accounts (Section 109).

Health Marketplace Pools: The bill allows for the formation of marketplace pools that can offer group health insurance to members without conditioning membership on health status (Section 202).

Improved Transparency for Health Plans: Health plan service providers must provide detailed, quarterly information regarding pricing, fee schedules, and all remuneration, including rebates and discounts, at no cost to the group health plan (Section 2799A-12(b)(1)).

Clearer Insurance Information for Patients: Group health plans and insurance issuers are required to provide notifications that include plain language descriptions of services, billing codes, the amount the plan is paying, and the patient's remaining cost-sharing and out-of-pocket totals (Section 310(a)(1) and (2)).

Enhanced Billing Clarity: Healthcare providers must provide written, itemized bills that include plain language descriptions, billing codes, and information regarding charity care policies (Section 311(a)(1)).

Protection Against Unexpected Medical Bills: Healthcare providers are prohibited from taking collection actions if they have not provided a required itemized bill or if the charges exceed the provided good faith estimate, unless the extra costs were due to unforeseen, documented medical necessities (Section 311(a)(2)).

Increased Access to Medication: The bill establishes a system for "expanded-access prescription drugs" to be dispensed and administered by qualified individuals like pharmacists and nurse practitioners (Section 501(a)(3)).

Lower Costs for Selected Drugs: For certain drugs subject to maximum fair price negotiation, manufacturers must pay rebates to the Federal Supplementary Medical Insurance Trust Fund, and beneficiary coinsurance is recalculated based on the negotiated price (Section 402(b)(1) and (2)).

Civil Monetary Penalties for Non-compliance: Hospitals, laboratories, imaging providers, and surgical centers could face significant daily fines if they fail to meet the new price transparency requirements (Sections 302, 303, 304, and 305).

Increased Administrative Requirements: The bill imposes new, strict disclosure and attestation requirements on hospitals and health insurance plans (Sections 302 and 306).

Strict Penalties for Providers: Health plan service providers that fail to provide required information may face civil penalties of $100,000 per day (Section 2799A-12(d)).

Financial Burdens on Healthcare Facilities: Healthcare providers that fail to comply with itemized billing requirements may be subject to penalties of up to $10,000 per instance (Section 311(b)(1)).

State-Level Restrictions on Medication Access: States have the authority to "opt-out" of the expanded-access drug provisions by maintaining laws that prohibit or limit the prescribing or dispensing of such drugs by covered individuals (Section 501(a)(3)(E)(ii)).