Transparency in (Health Plan) Coverage Regulations

[Marshall]

According to Centers for Medicare & Medicaid Services (https://www.cms.gov/healthplan-price-transparency)

Beginning July 1, 2022, most group health plans and issuers of group or individual health insurance will begin posting pricing information for covered items and services. This pricing information can be used by third parties, such as researchers and app developers to help consumers better understand the costs associated with their health care. More requirements will go into effect starting on January 1, 2023, and January 1, 2024 which will provide additional access to pricing information and enhance consumers' ability to shop for the health care that best meet their needs.

One of my clients informed that their health insurer said they had to provide a link on their website to the insurance company's plan as they, my client, is a public website. Reading the "final rule" [cms.gov...] I see it as the insurer, not the insured, has to provide this link.

Through this final rule, plans and issuers will also be required to disclose on a public website their in-network negotiated rates, billed charges and allowed amounts paid for out-of-network providers, and the negotiated rate and historical net price for prescription drugs.

Is anyone familiar with this? I find it odd that the insured needs to provide such a link as that would mean every website owned by a company that provides heath insurance would need to have such a link and that makes no sense.

[not2easy]

I am not sure I would want to have my health care provided by a company that cannot read and understand sentences. They are the "health plans and issuers of group or individual health insurance" part of that sentence, not their clients. How silly.

[Marshall]

I thought this was stupid when then emailed me about it, thinking the same thing as you. But I told them I would look into it.