On October 29, 2020, the Department of Health and Human Services (\u201cHHS\u201d), the Department of Labor (\u201cDOL\u201d), and Department of Treasury (\u201cDOT\u201d) collaborated to issue a final \u201ctransparency rule\u201d aimed at providing greater information to consumers, thereby allowing them to explore different healthcare options and avoid surprise billing for services rendered.\u00a0 Additionally, the rule requires the public disclosure of negotiated rates for in-network providers and amounts allowed for out-of-network providers.<\/p>\n
Disclosure of Provider Rates<\/em><\/strong><\/p>\n Under the rule, non-grandfathered health plans and insurers must publish their negotiated rates and allowable out-of-network charges on a public website, which is to be updated monthly through three machine-readable files.\u00a0 The website must be publicly available, accessible without charge, and cannot require a user account, password, or other credentials, or submission of personally identifiable information to access the files.\u00a0 Specifically, the files will reflect negotiated rates for in-network services, historical payments to and billed charges from out-of-network providers, and in-network negotiated rates.\u00a0 The files must also show historical net prices for covered prescription drugs at the pharmacy level.<\/p>\n