Congress Wants Hospital Price Transparency by 2028. DPC Practices Already Post Theirs.

Most DPC practice websites list the monthly membership fee right on the homepage. Typically $70 to $100 a month for an adult, according to DPC Alliance and DPC Frontier data. Lab prices posted by name. No billing codes, no negotiated rates, no “call for pricing.”

Congress wants the rest of healthcare to work the same way.

What the Bill Does

The Lower Costs, More Transparency Act (H.R. 9393) was introduced on June 23 and advanced through the House Energy and Commerce Health Subcommittee two days later as part of a 15-bill healthcare markup. The bill would require hospitals, clinical labs, imaging centers, and ambulatory surgical centers to publish their prices in consumer-friendly formats by January 1, 2028.

The requirements are specific. Hospitals would have to post standard charges, discounted cash prices, and their negotiated rates with each insurer for at least 300 common services. Health plans and insurers would need to provide real-time online tools showing each member’s out-of-pocket cost for any service from any provider. Labs, imaging centers, and surgical centers would have to post their cash prices publicly.

The bill also requires machine-readable pricing files from insurers so third-party tools can compare costs across plans and networks.

Stronger Enforcement Than Before

The CMS hospital price transparency rule took effect in 2021, requiring hospitals to post their negotiated rates online. Compliance was uneven. Enforcement amounted to warning letters and modest fines that large health systems could absorb without changing behavior.

H.R. 9393 raises the stakes. The bill establishes escalating penalties based on hospital size, with fines that can climb into the millions for repeat violations. Federal agencies would report to Congress on compliance levels, price trends, and technology adoption starting in 2028 and 2029.

A previous version of this bill passed the House in the 118th Congress with bipartisan support. The reintroduction and rapid subcommittee advancement suggest the political appetite for healthcare price transparency hasn’t faded.

DPC Was Built on This Principle

This bill reads as familiar to DPC physicians. The model was founded on the principle the legislation is trying to mandate.

A DPC practice charges a flat monthly fee and publishes it. Labs cost what they cost. Medications are dispensed at wholesale or near-wholesale pricing (physician dispensing regulations vary by state; physicians are responsible for verifying their state’s requirements). The patient knows the price before the service, every time.

That’s a structurally different arrangement from what H.R. 9393 is trying to fix. When a hospital negotiates different rates with different insurers, and those rates aren’t published, patients can’t comparison-shop. The bill would force that information into the open.

DPC skipped the problem entirely. There are no negotiated rates to disclose because there are no insurers in the transaction. The price is the price. More than 3,000 DPC practices across the U.S. have operated this way from the start, according to DPC Alliance data.

What This Means

H.R. 9393 doesn’t mention direct primary care. The compliance requirements target hospitals, labs, and insurers.

But the political signal matters. When Congress mandates price transparency for the rest of healthcare, it validates something DPC physicians figured out years ago: patients respond to knowing what a service costs before they receive it. The fact that it takes federal legislation and escalating fines to make that happen in hospitals says something about how far the traditional system has drifted from what patients now expect.

The implementation date is January 1, 2028. DPC practices have a head start measured in years, not months. And a previous version of this bill already cleared the House once, which makes full passage more likely than the typical healthcare bill.

For physicians who post their pricing on the homepage, the rest of healthcare is being told to do what you’ve always done. It took an act of Congress to get there.