Recently, President Donald Trump issued an executive order (EO) directing federal agencies to issue new guidance to improve health care price transparency. This EO aims to promote a more competitive, innovative, affordable and higher-quality health care system.
Health Plan Price Transparency
The Departments of Labor, Health and Human Services, and the Treasury (Departments) issued a final rule in November 2020 that imposed new transparency requirements on group health plans and health insurance issuers:
- Machine-readable files (MRFs): Effective July 1, 2022, health plans and issuers must disclose detailed pricing information in three MRFs on a public website.
- Self-service price comparison tool: Health plans and issuers must make an internet-based self-service price comparison tool available to participants, beneficiaries and enrollees. For plan years beginning on or after Jan. 1, 2023, price comparison information was required for 500 items and services. For plan years beginning on or after Jan. 1, 2024, price comparison information must be available for all covered items and services.
The EO
The EO directs the Departments to take the following actions within 90 days:
- Require the disclosure of actual prices of items and services, not estimates.
- Issue updated guidance or proposed regulations, ensuring pricing information is standardized and easily comparable.
- Issue guidance or proposed regulations updating enforcement policies designed to ensure compliance with the transparent reporting of complete, accurate and meaningful data.
Although most employers rely on their issuers or third-party administrators to satisfy many transparency requirements, employers should still monitor this topic for additional guidance from federal agencies.
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