Executive Order – Pricing Transparency
At the end of February, President Trump issued an Executive Order directing several federal agencies to further implement, enforce and possibly expand existing federal transparency regulations.
The existing transparency regulations require hospitals and health plans to, amongst other things:
- publish machine readable files with pricing and reimbursement data; and
- provide consumers with price comparison tools.
The hope is that further price transparency will help lower healthcare costs over time, but adoption of, and compliance with, the requirements has been slow. The new executive order does not make any immediate changes, but we are likely to see further action via regulations and potentially even new legislation, so it is something to watch.
For the most part, insurance carriers and TPAs handle these requirements on behalf of group health plans, so employers do not have much responsibility other than to confirm their service vendors are complying.
Level Funded and Self-funded plans should be talking to their carriers or TPAs to make sure they are complying with this transparency regulation.