Final Health Plan Transparency Regulations Issued

Author: Scott Wold, Assistant Vice President of Regulatory and Legislative Strategy

In late October, the DOL, IRS, and CMS issued final regulations (referred to in this article as the “Health Plan Transparency Regulations” or the “Regulations”) implementing two significant health plan pricing transparency initiatives. These regulations further the Trump Administration’s goal of improving health care pricing and quality transparency, a goal previously announced in an Executive Order issued in June 2019. The Regulations build on previously issued regulations addressing hospital price transparency.  According to a Fact Sheet released by CMS along with the final regulations, the Regulations “will empower consumers to shop and compare costs between specific providers before receiving care” and “will drive innovation, support informed, price-conscious decision-making, and promote competition in the health care industry.”

The purpose of this article is to identify who is impacted by the final regulations, describe the actions required by the final regulations, and identify some steps employers should be taking to prepare for compliance.

This document is provided for general information purposes only and should not be considered legal or tax advice or legal or tax opinion on any specific facts or circumstances. Readers are urged to consult their legal counsel and tax advisor concerning any legal or tax questions that may arise.

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