penalties under this paragraph in the same manner as such provisions apply to civil monetary penalties under subsection (i)(1) of such section. (5) Method for determining actual charge Not later than 18 months after the date of the enactment of the Hospital Price Transparency and Disclosure Act, the Secretary shall pursuant to rulemaking develop a method to determine and make publicly available information on total amounts actually negotiated for and charged by a hospital to patients for the items and services appearing on its standard charge list, and accepted by the hospital as payment in full. In determining the method for the disclosure of such negotiated charges, the Secretary may take steps to reduce the risk of the anti-competitive use of such data or market collusion, such as by using averages, ranges, rankings, trends, or other means as the Secretary determines reasonable. (6) Reports Beginning not later than 18 months after the date of the enactment of the Hospital Price Transparency and Disclosure Act, and annually thereafter, the Secretary shall make public on the Internet site described in paragraph (3)(A) a report analyzing trends in standard and negotiated charges over time, analyzing trends in standard and negotiated rates relative to Medicare payments, and providing recommendations as needed on statutory changes to increase medical price transparency and public insight into health care pricing. .