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November 05, 2020

Transparency in Coverage

On October 29, the Departments of HHS, Treasury, and Labor issued the “transparency in coverage” final rule. This final rule imposes new transparency requirements on group health plans and health insurers in the individual and group markets. HHS also released an accompanying fact sheet and press release. The final rule will require insurers to disclose out-of-pocket cost information, and the underlying negotiated rates, for all covered health care items and services, including prescription drugs, through an internet-based self-service tool and in paper form upon request.

This is the companion rule to a 2019 health care facility price transparency final rule that, barring legal challenges, will go into effect on January 1.