Insiders: Biden May Revisit Payer Price Transparency Rule

While President-elect Joe Biden’s administration will likely move forward with some type of health insurer price transparency regulation, industry insiders say the new policy will likely differ from the rule the Trump administration recently finalized (HPW 11/6/20, p. 1).

“I think that the [new] administration will take a step back and think carefully about what makes the most sense,” Avalere Health Founder Dan Mendelson tells AIS Health. Mendelson doubts that the Trump administration rule will actually have an impact at the consumer level. Under the rule, by January 2023 health plans must offer members online shopping tools that allow them to see the negotiated rate between their provider and their plan, as well as a personalized estimate of their out-of-pocket cost for 500 of the most shoppable items and services. Effective one year later, those shopping tools will have to show the costs for all remaining items and services.

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Peter Johnson

Peter Johnson

Peter has worked as a journalist since 2011 and has covered health care since 2020. At AIS Health, Peter covers trends in finance, business and policy that affect the health insurance and pharma sectors. For Health Plan Weekly, he covers all aspects of the U.S. health insurance sector, including employer-sponsored insurance, Medicaid managed care, Medicare Advantage and the Affordable Care Act individual marketplaces. In Radar on Drug Benefits, Peter covers the operations of (and conflicts between) pharmacy benefit managers and pharmaceutical manufacturers, with a particular focus on pricing dynamics and market access. Before joining AIS Health, Peter covered transportation, public safety and local government for various outlets in Seattle, his hometown and current place of residence. He graduated with a B.A. from Colby College.

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