HHS Finalizes Updated Price Transparency Rules for Health Plans

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2▲0 ▼5Impact / 5
Summary · why it matters

The U.S. Department of Health and Human Services has finalized an update to its Transparency in Coverage rules aimed at helping health plan enrollees understand how much they will pay before receiving care. The new rules provide more context about in-network prices, expand out-of-network pricing information, and strengthen accountability for the accuracy of published data. Group health plans and insurers must also give consumers personalized cost-sharing information by phone, a service they already provide online. The Transparency in Coverage rules were initially established in November 2020 during President Trump's first term. HHS said the top 25% of the most expensive healthcare service prices have dropped by 6.3% per year following those price transparency requirements.

Impact on assets 5

Health Care▼
Cigna Corp
CI
▼ NegativeRegulationrelevance

New HHS price transparency rules expand out-of-network pricing disclosure and accountability requirements for insurers like Cigna.

CVS Health Corp
CVS
▼ NegativeRegulationrelevance

As a major health insurer, CVS Health faces added compliance and disclosure burdens under the finalized Transparency in Coverage rules.

Elevance Health Inc
ELV
▼ NegativeRegulationrelevance

Elevance Health must comply with expanded in-network and out-of-network price transparency and accuracy accountability rules.

Oscar Health Inc
OSCR
▼ NegativeRegulationrelevance

Oscar Health, as a health plan, faces the new transparency and personalized cost-sharing disclosure requirements.

Aging Population▼
UnitedHealth Group Incorporated
UNH
▼ NegativeRegulationrelevance

UnitedHealth's insurance plans must meet the finalized transparency rules, including phone-based personalized cost-sharing information.