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Following July 1, 2022, most group health plans and issuers of group or individual health insurance across the country are required to disclose pricing information of negotiated rates for healthcare services between insurer and provider under the new Federal Price Transparency Rule (The Rule). The stated purpose of The Rule is to “empowering consumers with the necessary information to make informed health care decisions.”
The information is to be rolled out in 3 stages:
Stage 1: Machine-Readable Files containing the costs for items and services related to in-network rates and allowed amounts.
Stage 2: Internet-based price comparison tool (also available by phone, or in paper form, upon request) allowing an individual to receive an estimate of their cost-sharing responsibility for a specific item or service from a specific provider or providers by January 1, 2023.
Stage 3: Internet-based price comparison tool (or disclosure on paper, upon request) allowing an individual to receive an estimate of their cost-sharing responsibility for a specific item or service from a specific provider or group of providers, for all items and services by 2024…