The Uncertain Future of the Transparency in Coverage Rule
This Briefing is brought to you by AHLA’s Payers, Plans, and Managed Care Practice Group.
- November 25, 2020
- Chris Bennington , Bricker & Eckler LLP
- Joel L. Michaels , Arizona State University
On October 29, 2020, the Departments of Health and Human Services, Labor, and the Treasury (Departments) issued the Transparency in Coverage final rule (Rule), which imposes new price transparency requirements on health insurers and group health plans (hereinafter both are referred to as “health plans”). This Rule complements a similar hospital price transparency rule issued in 2019; both rules came at the direction of President Trump’s executive order that same year on Improving Price and Quality Transparency in American Healthcare to Put Patients First. The 2020 Rule establishes disclosure requirements related to the cost sharing features of health plans to enrolled individuals (referred to as “enrollees”) as well as to the general public (referred to as “consumers”). A primary goal of the Rule is to ensure enrollees and consumers are empowered with information they need to make informed health care coverage decisions. Yet, the Rule presents significant policy and legal considerations, raising questions whether it will be substantially revised by executive action (e.g., further deferrals of existing compliance dates), or successfully challenged in court before its disclosure provisions take effect.
ARTICLE TAGS
You must be logged in to access this content.