On October 29, 2020, the Departments of Labor, Health and Human Services, along with the Treasury Department issued the final rule regarding health care transparency requirements for group health plans and insurers. The rules apply only to those plans that have grandfathered status under the Affordable Care Act (ACA).
The final rule is a result of the executive order that was issued on June 24, 2019 with the goal of improving price quality and transparency in health care. The focus of the transparency provisions is for health plans and insurers to be held to standards that provide price and cost-sharing information to consumers upon their requests as well as disclosing negotiated rates for providers and the out-of-network historical costs.
The rule has a phased-in approach for the rollout with milestones to be reached in 2022, 2023, and 2024. With the election and anticipated continued challenges to the rule, there stands a chance that the rule may change prior to full implementation. Thus, the noted implementation dates may be subject to change.
Contact your Cowden representative for more information on this or other compliance issues.