| Course | HA 610 Health Policy and Management |
|---|---|
| Unit | Unit 2 |
| Paper type | Legislative analysis |
| Length | About 1,000 words, 6 pages |
| Format | APA 7 student paper |
| School | Herzing University |
| Program | MS in Healthcare Administration |
| Updated | October 2026 |
Free sample paper for HA 610 Unit 2
H.R. 5378, Section 101: What the Lower Costs, More Transparency Act Would Have Changed for a 180-Bed Hospital, Provision by Provision
Student Name
Health Care Administration, Herzing University
HA 610: Health Policy and Management
Instructor Name
January 23, 2026
H.R. 5378, Section 101: What the Lower Costs, More Transparency Act Would Have Changed for a 180-Bed Hospital, Provision by Provision
The Bill as It Exists
H.R. 5378, the Lower Costs, More Transparency Act, was introduced in the House of Representatives in the 118th Congress by Representative Cathy McMorris Rodgers of Washington, with Representatives Frank Pallone of New Jersey, Jason Smith of Missouri, and Virginia Foxx of North Carolina, the chairs and ranking members of the committees with jurisdiction. It was referred to the Committee on Energy and Commerce and, in addition, to the Committees on Ways and Means and on Education and the Workforce. The House passed an amended version on December 11, 2023. It was received in the Senate and not taken up before the 118th Congress ended, so it did not become law (Lower Costs, More Transparency Act, 2023).
The bill has eleven sections in its first title on health care transparency, covering hospitals, clinical laboratories, imaging providers, ambulatory surgical centers, health coverage, and pharmacy benefits, plus reports and an advisory committee. This analysis stays with Section 101, hospital price transparency, because it is the section that would have created new obligations for the composite 180-bed nonprofit community hospital used in this course. The writer would check whether a successor bill has been introduced in the current Congress before relying on this analysis for advocacy.
The Provisions That Matter, and the Obligations They Create
Codification. Section 101 would have added a new section 1899C to the Social Security Act requiring that, beginning January 1, 2026, each specified hospital receiving Medicare payment "compile and make public (without subscription and free of charge) for each year" all of its standard charges and consumer-friendly price information. Today these requirements exist only in regulation, at 45 CFR Part 180, issued under a broad authority in the Public Health Service Act (Centers for Medicare & Medicaid Services [CMS], 2019). Obligation for the hospital: little change in what it must publish, but a change in legal footing. A requirement written into statute is harder for a future administration to loosen and harder to challenge in court.
Dollar amounts. The bill would have required payer-specific negotiated charges "expressed as a dollar amount," clearly associated with the name of the payer and plan. Obligation: for our five contracts that pay certain services as a percentage of charges, the hospital would have to convert those terms into dollar figures for every item and service, a larger task than the current rule's approach of allowing the percentage or algorithm to be posted with additional allowed-amount data (CMS, 2025).
Shoppable services and missing services. The consumer display must cover at least 300 shoppable services and, for each service CMS specifies that the hospital does not furnish, include "an indication that such service is not so furnished." Obligation: a small change, adding explicit not-offered markers, which would also stop patients from assuming that a missing service is simply unpriced.
Attestation. The hospital must include "an attestation that all information made public pursuant to this subparagraph is complete and accurate." Obligation: comparable to the attestation CMS added by regulation for 2026, but carried in statute.
Cash price and charity care. Where no discounted cash price exists, the hospital must post the median cash price charged to self-pay patients over the previous three years and link to a plain-language explanation of its charity care policy. Obligation: finance and patient financial services would need to calculate a three-year median and publish the financial assistance policy alongside prices.
Language access. The section directs hospitals to take reasonable steps to make the information accessible to people with limited English proficiency. Obligation: translation of the consumer display into the most common languages in the service area.
Monitoring and Enforcement
The Secretary would have had to review every hospital's compliance at least once every three years and publish enforcement activity on the CMS website. After a finding of noncompliance, a hospital would receive a notification within 30 days and could be asked for a corrective action plan; failure to comply within 45 days would expose it to civil monetary penalties.
The penalty schedule is the provision with the clearest financial effect. For a hospital with more than 100 but fewer than 201 beds, the maximum would be $17.50 per bed per day, rising to $20 per bed per day after a year of noncompliance. For our 180-bed hospital that is up to $3,150 a day, or about $1.15 million over a year, and more after the first year. The current regulation's maximum for a hospital of this size is lower, calculated at $10 per bed per day. The bill also allowed further increases for hospitals found knowingly and willfully noncompliant twice in a year.
Fiscal Effect
The Congressional Budget Office published an estimate of the bill's direct spending and revenue effects (Congressional Budget Office [CBO], 2023). For an individual hospital, the relevant fiscal effect of Section 101 is not federal spending but compliance cost and penalty exposure. For our hospital, the dollar-amount requirement is the main cost driver: converting percentage-based terms into dollar figures across the chargemaster would require either a contract change or a recurring analytic process, estimated internally at $60,000 to $90,000 in the first year beyond current compliance costs.
What This Means for the Hospital
Although H.R. 5378 did not become law, its hospital section shows the direction of federal policy on three points: prices as dollar amounts rather than formulas, personal accountability through attestation, and higher penalties for larger hospitals. The CMS regulation for 2026 has moved in the same direction on attestation and on data for percentage-based contracts. A hospital planning its compliance work would be prudent to design for the stricter version. The most practical step for our hospital is the one identified in the Unit 1 brief: pursue fixed-dollar rates at contract renewal, which would satisfy both the current rule and any future statute modeled on this bill. The hospital is composite; the bill text is quoted from the version passed by the House.
References
Centers for Medicare & Medicaid Services. (2019). Medicare and Medicaid programs: CY 2020 hospital outpatient PPS policy changes and payment rates and ambulatory surgical center payment system policy changes and payment rates. Price transparency requirements for hospitals to make standard charges public. Federal Register, 84, 65524. https://www.federalregister.gov/d/2019-24931
Centers for Medicare & Medicaid Services. (2025). Medicare program: Hospital outpatient prospective payment and ambulatory surgical center payment systems; quality reporting programs; overall hospital quality star rating; hospital price transparency; and notice of closure of a teaching hospital and opportunity to apply for available slots. Federal Register, 90, 53448. https://www.federalregister.gov/d/2025-20907
Congressional Budget Office. (2023). Estimated direct spending and revenue effects of H.R. 5378, the Lower Costs, More Transparency Act. https://www.cbo.gov/publication/59825
Lower Costs, More Transparency Act, H.R. 5378, 118th Cong. (2023). https://www.congress.gov/bill/118th-congress/house-bill/5378
HA 610 Unit 2 instructions, in plain terms
Unit 2 asks you to analyze a bill and its likely effects on a health care organization. Expect to describe the bill and its status, explain the key provisions and the obligations they create, describe monitoring and enforcement, report the fiscal effect and explain what it means for your organization. Students often ask whether to choose a bill that passed and how to find the fiscal estimate. A bill that did not pass can still be useful if it signals direction. Use Congress.gov for text and actions and the CBO for fiscal estimates. Quote or closely summarize the bill's own language. Translate provisions into obligations an organization would have to meet.
How this HA 610 Unit 2 example is built
The analysis opens with the bill's number, sponsors, House vote and dates. The provisions section summarizes Section 101 in plain language and lists each obligation it would have created, such as posting actual dollar prices and attesting to accuracy. The enforcement section explains how compliance would have been reviewed and how penalties would have scaled with bed count. The fiscal section reports the CBO estimate and what drives it. The organization section explains why the hospital should prepare anyway, since the final CMS rule moved in the same direction. Every point cites either the bill's own language or the CBO. The analysis turns legislative language into a list of what a hospital would need to do, which is what an administrator needs.
HA 610 Unit 2 rubric: what full points look like
Herzing's rubric for a legislative analysis typically covers bill identification, accuracy about provisions, enforcement, fiscal effect and organizational implications. Accuracy about provisions carries the most weight, because administrators plan from what a bill actually says rather than how it was described in the press. Identification points reward number, sponsors, chamber votes and current status. Enforcement criteria look for review processes and penalty structures stated correctly. Fiscal points go to the CBO estimate explained in plain terms. Implications earn credit when provisions are translated into concrete obligations for the organization. Noting that a bill died while showing why it still matters is often credited. Concise organization helps. Congress.gov records and the CBO cost estimate anchor the analysis.
HA 610 Unit 2 help before you submit
Legislative analyses in HA 610 Unit 2 commonly lose points by summarizing news about the bill instead of its text. Another frequent problem is ignoring status, so a bill that stalled in the Senate is treated as law. Students often skip the fiscal estimate. Enforcement is not described, so the stakes are unclear. Implications are vague, such as hospitals will need to comply. Provisions are listed without the obligations they create. Related regulations, such as the CMS rule, are not connected. Section numbers are missing. Stakeholder positions on the bill are left out. Finally, translate the bill into what an organization would have to do, because graders reward analysis an administrator could plan from.
Get a HA 610 Unit 2 example written to your instructions
Send the Unit 2 instructions and the rubric from your HA 610 classroom, plus the bill number or the policy area your section set. We write a custom example that reads the bill text itself, converts the provisions into obligations and weighs its chances, and return it in 24 to 48 hours. The first custom sample is free.
More HA 610 papers and healthcare administration samples
- HA 610 Unit 1: Policy brief
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- HA 610 Unit 4: Stakeholder position paper
- HA 610 Unit 5: Public comment letter
- HA 610 Unit 6: Testimony statement
- HA 610 Unit 7: Advocacy plan
- HA 610 Unit 8: Policy recommendation memo
- HA 625 Unit 2: Consent policy analysis
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HA 610 Unit 2 questions, answered
Does the bill have to be a current one?
Check your instructions, because some sections require a measure still in play and others allow one that already passed or died. A live bill gives the analysis a real recommendation to make, since your organization can still act. A closed one lets you check your reading against what actually happened, which is its own kind of evidence.
State bill or federal bill?
Either works, and state measures are often the better choice. They move faster, they are shorter, the committee record is easier to reach, and the obligations land directly on organizations in one place you can name. Federal bills carry more literature but also more noise, and a large omnibus measure can swallow the analysis before any provision has been read closely.
How much of the bill text should be quoted?
Only the lines that carry an obligation, and then in short form with the section number beside them. Long block quotations eat space the analysis needs and tend to replace reasoning rather than support it. One quoted clause followed by two sentences on what it would mean operationally reads far stronger than a page reproduced from the legislative site.
Where can I find a free HA 610 Unit 2 sample paper?
Read the complete HA 610 Unit 2 legislative analysis here at no charge, H.R. 5378 Section 101 translated into hospital obligations. Ask for a custom analysis of another bill.
What was the Lower Costs, More Transparency Act?
A 2023 House bill that would have written hospital price transparency into statute, required dollar amounts and scaled penalties by hospital size. This sample analyzes its hospital section and what it signals for future policy.