The Biden administration has given healthcare organizations extra time to comply with a price transparency rule.
The Trump-era rule, called Transparency in Coverage, aims to ensure patients know how much they will owe when they go to the doctor or undergo certain procedures or treatments. The rule was originally slated to go into effect Jan. 1, 2022, with health plans and insurers required to disclose on a public website information regarding:
- In-network provider rates for covered items and services
- Out-of-network allowed amounts and billed charges for covered items and services
- Negotiated rates and historical net prices for covered prescription drugs
However, healthcare organizations now have until July 1, 2022, to comply and post in-network rates and out-of-network allowed amounts. Other provisions of the rule, including the publication of prescription drug costs, will also not be enforced indefinitely. That’s because stakeholders expressed concern over duplicate rules and a changed regulatory landscape since the rule was first published.
The rule intends to help consumers understand healthcare costs better, with the aim that consumers will shop around for the best price and quality. However, studies have shown consumers don’t really shop around when it comes to healthcare.
The Trump administration published another price transparency rule that forced hospitals to publish their prices of the most common procedures. Despite going into effect, only a small percentage of hospitals have complied with the rules. The lack of compliance has prompted HHS to consider higher civil penalty fines.
Amy joined TriMed Media as a Senior Writer for HealthExec after covering home care for three years. When not writing about all things healthcare, she fulfills her lifelong dream of becoming a pirate by sailing in regattas and enjoying rum. Fun fact: she sailed 333 miles across Lake Michigan in the Chicago Yacht Club "Race to Mackinac."