New Rule Requires Payers To Post Negotiated Rates, Cost-sharing Data

The Trump administration announced today that it has finalized a rule requiring private insurers to provide members with upfront prices negotiated with providers–including cost-sharing data. Starting in 2023, payers will be required to offer an online shopping tool that includes out-of-pocket cost estimates and negotiated prices for 500 common services—to be extended to all services in 2024. Payers will also be required to post in-network negotiated provider rates, out-of-network coverage rates and in-network drug pricing starting in 2022. “For too long, American patients have been at the mercy of a shadowy system that hides crucial information,” HHS Secretary Azar said. “This shadowy system needs to change.” Read more here.

(Source: Paige Minemeyer, Fierce Healthcare, 10/29/20)