STAND. COM. REP. NO. 1241-26

Honolulu, Hawaii

, 2026

RE: S.B. No. 2277

S.D. 1

H.D. 1

Honorable Nadine K. Nakamura

Speaker, House of Representatives

Thirty-Third State Legislature

Regular Session of 2026

State of Hawaii

Madame:

Your Committee on Health, to which was referred S.B. No. 2277, S.D. 1, entitled:

"A BILL FOR AN ACT RELATING TO HOSPITAL PRICE TRANSPARENCY,"

begs leave to report as follows:

The purpose of this measure is to:

(1) Require each hospital in the State to comply with federal price transparency requirements;

(2) Require the Department of Health to monitor and enforce compliance with federal price transparency requirements;

(3) Establish a process for patients to challenge a debt collection lawsuit filed by a hospital if the hospital was not in compliance with price disclosure and transparency requirements;

(4) Require the Department of Health to publish a list of any enforcement actions taken against non-compliant hospitals; and

(5) Require hospitals to provide easily accessible itemized bills to patients prior to any debt collection or legal actions being taken against the patient.

Your Committee received testimony in support of this measure from the State Health Planning and Development Agency. Your Committee received testimony in opposition to this measure from the Department of Health and Healthcare Association of Hawaii. Your Committee received comments on this measure from the Department of Commerce and Consumer Affairs and one individual.

Your Committee finds that many state residents struggle with increasing health care costs and often have limited knowledge of health care pricing, particularly for hospital care. Your Committee further finds that although the federal Public Health Service Act requires each hospital in the United States to make all standard charges publicly available, a 2024 report indicated that no major hospital system in Hawaii is fully compliant with federal price transparency requirements. Your Committee believes that establishing a framework to ensure compliance with federal hospital price transparency requirements will enable Hawaii residents to make more informed decisions about their health care needs.

Your Committee recognizes concerns raised in testimony that creating a state framework for hospital price transparency requirements would be duplicative of existing federal requirements and is likely to create additional administrative burdens for hospitals in Hawaii without meaningfully improving consumer protection.

Accordingly, your Committee has amended this measure by:

(1) Requiring the State Health Planning and Development Agency, rather than the Department of Health, to monitor compliance with federal hospital price transparency requirements and placing the new statutory language in Chapter 323D, Hawaii Revised Statutes, rather than Chapter 321, Hawaii Revised Statutes;

(2) Inserting language requiring hospitals licensed in the State to provide an annual attestation that the hospital is in compliance with federal hospital price transparency requirements and authorizing the State Health Planning and Development Agency to rely on this attestation when monitoring hospitals for compliance;

(3) Specifying that hospitals are not in violation of hospital price transparency requirements if the hospitals are participating in a compliance or corrective action process with the Centers for Medicare and Medicaid Services;

(4) Deleting language establishing requirements for hospital pricing list publication, enforcement, civil penalties, and debt collection actions;

(5) Clarifying that a patient subject to a lawsuit for medical debt collection from a hospital may initiate a counterclaim to determine if the hospital was noncompliant with federal hospital price transparency requirements on the date items or services were provided or purchased;

(6) Deleting language making violations of federal hospital price transparency requirements an unfair or deceptive act or practice in the conduct of any trade or commerce;

(7) Deleting language stating the remedies provided by this measure are in addition to and not exclusive of any other remedies provided by law;

(8) Deleting the preamble; and

(9) Making technical, nonsubstantive amendments for the purposes of clarity, consistency, and style.

As affirmed by the record of votes of the members of your Committee on Health that is attached to this report, your Committee is in accord with the intent and purpose of S.B. No. 2277, S.D. 1, as amended herein, and recommends that it pass Second Reading in the form attached hereto as S.B. No. 2277, S.D. 1, H.D. 1, and be referred to your Committee on Consumer Protection & Commerce.

Respectfully submitted on behalf of the members of the Committee on Health,

____________________________

GREGG TAKAYAMA, Chair