The Pharmaceutical Care Management Association (PCMA) has filed suit to challenge parts of the Trump administration’s insurer price transparency rule, which was finalized in late October 2020, writes Fierce Healthcare.
Under the rule, private payers are required to provide patients upfront with pricing details that have been negotiated with providers, including real-time cost-sharing data.
Beginning in 2023, insurers must offer an online tool that provides out-of-pocket cost estimates for 500 of the “most shoppable” services. By 2024, that platform must extend to all services, according to the rule. Insurers argued that launching these tools would be a costly endeavor that would provide data that confuses consumers. The PCMA is directly challenging a part of the rule that would require its pharmacy benefit manager members to report the historical pricing data on prescription drugs. The group said it was not challenging other transparency tenets in the rule.