The federal price transparency rules require hospitals and health plans to provide both a consumer-facing price lookup tool and machine-readable files with all their prices.

A proposed rule from HHS would add non-price contextual data to transparency files, such as plan enrollment numbers and which providers have billed for a specific service.

Health plans are estimated to post approximately one trillion prices per month in machine-readable files as part of the Transparency in Coverage rule.

Data users have requested that the Centers for Medicare & Medicaid Services (CMS) create a central repository for links to all health plan price transparency files to improve accessibility.

The Trump administration implemented a rule for hospital price transparency and a separate rule for health plan price transparency, known as the Transparency in Coverage rule.

The Department of Health and Human Services (HHS) has released a proposed rule to address usability issues with health plan price transparency data files, with a comment period that ended in March 202...

The Department of Health and Human Services (HHS) estimates that removing clinically implausible "ghost codes" from price transparency files will reduce their size by 70%.

The Consolidated Appropriations Act of 2021 included a provision for an "Advanced Explanation of Benefits" to give patients upfront cost disclosures, but this has not yet been implemented.

Insurers commenting on the proposed price transparency rule generally support streamlining efforts but oppose the requirement to add extra ancillary information to the data files.

Access to insights from Transparency in Coverage data is currently dominated by specialized data firms that can manage the high cost and complexity of ingesting and cleaning the massive datasets.

A proposed HHS rule would change the reporting frequency for health plan price transparency data from monthly to quarterly.

Employer-sponsored health plans provide coverage for approximately half of all working-age adults in the United States.

Data users, including employers and researchers, have commented that the proposed HHS price transparency rule needs to go further by addressing data accuracy issues and requiring more utilization data...

Insurers have requested a compliance timeline of 12 to 18 months after technical guidance is finalized for the new price transparency rule, which is longer than the proposed 12 months after the rule's...

The current proposed HHS rule on price transparency does not include any new provisions for compliance checks on health plans.