PBMs, Not Insurers, Lead Legal Challenge of Transparency Rule

Even after a rule requiring unprecedented price transparency from hospitals was upheld in federal court, it remained unclear whether the health insurance industry would go to court to challenge a similar rule targeting their industry. Now, just months from when the “transparency in coverage” regulation is slated to go into effect, that question has an unexpected answer: A lawsuit has been filed, but not by health insurers.

Instead, the U.S. Chamber of Commerce and chief PBM trade group Pharmaceutical Care Management Association (PCMA) filed a pair of lawsuits seeking to strike down the transparency in coverage rule, which was proposed in November 2019 and finalized last October. While it isn’t clear yet how the courts will respond to the litigation, one health insurer trade group says plans are proceeding as though the rule will be implemented as written.

0 Comments
© 2023 MMIT
Leslie Small

Leslie Small

Leslie has been reporting and editing in various journalism roles for nearly a decade. Most recently, she was the senior editor of FierceHealthPayer, an e-newsletter covering the health insurance industry. A graduate of Penn State University, she previously served in editing roles at newspapers in Pennsylvania, Virginia and Colorado.

Related Posts

denied-stamp
May 26

Rising Rate of Claims Denials Suggests Need for Better Payer-Provider Relations

READ MORE
businessman-viewing-news-update-journalism-headline-on-a-laptop
May 26

News Briefs: AHIP CEO Will Step Down in the Fall

READ MORE
a-woman-taking-taxi
May 26

Payers Can Help Tackle Transportation Barriers That Stymie Health Care Access

READ MORE

GAIN THERAPEUTIC AREA-SPECIFIC INTEL TO DRIVE ACCESS FOR YOUR BRAND

Sign up for publications to get unmatched business intelligence delivered to your inbox.

subscribe today