John Commins | December 30, 2019
The rule would require insurers to disclose negotiated rates for in-network providers and allowed amounts paid for out-of-network providers.
CMS says the 15-day extension was needed to account for robust public feedback and the consideration of the holiday season.
The proposed rule would mandate that consumers have real-time access to cost-sharing information, including out-of-pocket expenses.
The federal government has extended by two weeks the comment period for a proposed rule mandating price transparency from health insurers on out-of-pocket costs for consumers.
The Centers for Medicare & Medicaid Services said in a media release that the 15-day extension that ends on January 29 was needed to account for robust public feedback and the consideration of the holiday season.
If finalized, the proposed Transparency in Coverage Rule would mandate that consumers have real-time access to cost-sharing information, including out-of-pocket expenses, through a user-friendly online tool that most group health plans and health insurance issuers would be required to have.
The rule would also require insurers to disclose on their websites their negotiated rates for in-network providers and allowed amounts paid for out-of-network providers.
The rule goes into effect in 2021.
“Making this information available to the public is intended to drive innovation, support informed, price-conscious decision-making, and promote competition in the healthcare industry,” CMS said of the proposed rules.
The proposed rule on health plan transparency was unveiled on November 15, as one of two rules mandating price transparency from hospitals and insurers. Both proposals were met with a chorus of boos from payers and providers.
Earlier this month, providers filed suit to stop the proposed rule on hospital transparency, which takes effect on January 1, 2021.
Matt Eyles, president and CEO of America’s Health Insurance Plans, said in November that price transparency “should aid and support patient decision-making, should not undermine competitive negotiations that lower patients’ health care costs, and should put downward pressure on premiums for consumers and employers.”
“Neither of these rules—together or separately—satisfies these principles,” he said.
Anticipating the blowback, President Donald Trump on November 15 joked that insurers would be “thrilled” by the mandate.
“This will allow you to see your out-of-pocket costs and other vital price information before you go in for treatment, so you’re going to know what it’s going to be and you’re going to be able to have lots of choices, both in terms of doctors, hospitals, and price,” he said.
Source: Health Leaders Media
https://www.healthleadersmedia.com/strategy/feds-extend-comment-period-health-insurance-transparency-rule
