Certain health insurers are required to start publicly disclosing in-network and out-of-network rates commencing July 1 under a price transparency rule finalized two years ago, writes Healthcare Dive. The rule went into effect in January 2022, but CMS delayed enforcing this part of the price transparency rule, citing the “considerable time and effort” required to make the machine-readable files available the way the regulations require (AHT 8/2021). Since July 1, most group health plans and issuers of group or individual health insurance must post the cost files online, and update them at least once a month. Noncompliant plans could be fined up to $100 per day for each violation and each patient affected by the violation, a price tag that could become steep for companies with a large number of beneficiaries.
- Healthcare Dive: https://www.healthcaredive.com/news/insurer-price-transparency-takes-effect-compliance/626449/
- AboutHealthTransparency (8/24/2021): CMS Delays Enforcement of Major Parts of Price Transparency Rule until July 1 2022