On November 15, the Departments of the Treasury, Labor, and Health and Human Services (collectively the “Departments”) released a proposed rule imposing new transparency requirements on insurers and group health plans.
The proposed rule comes in response to the Trump Administration’s June 2019 Executive Order which directed the Departments to solicit comments on how consumers could receive cost-sharing information from insurers and plans before receiving care. To that end, the proposed rule requires insurers and plans to grant consumers ready access to certain information needed to estimate the potential out-of-pocket costs associated with a given health care item or service from a particular provider (e.g., estimated cost-sharing liability, accumulated cost-sharing amounts incurred to date, negotiated rates for in-network providers, etc.).
The proposed rule also makes changes to the Medical Loss Ratio methodology to incentivize insurers to develop “innovative benefit designs” that encourage consumers to shop for “lower cost, higher value” providers.
Comments on the proposed rule are due on January 14, 2020. A memorandum describing the proposal can be found here.