Some Insurers May Not Be Ready for Price Transparency Mandates

Insurer price transparency rules are finally starting to come into effect after years of litigation and administrative delays, but it’s not clear whether insurers will be compliant when deadlines arrive. Health care insiders tell AIS Health, a division of MMIT, that larger carriers have an advantage in implementation and smaller insurers may have a more difficult time keeping up.

Federal enforcement of payer price transparency rules by HHS and the departments of Labor and Treasury will begin on July 1 of this year. That deadline, during which plans will need to “make public machine-readable files disclosing in-network rates and out-of-network allowed amounts and billed charges,” per a government document, is the first of many health plan transparency requirements that will come into effect over the next two years.

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