Lexology November 19, 2020
On November 12, 2020, the Trump administration published its final rule on price transparency (the “Final Rule”) requiring affected entities to publicly release personalized information on out-of-pocket costs as well as certain negotiated rates, stating that transparency in health coverage requirements will improve competition and “strengthen America’s health care system by giving health care consumers, researchers, regulators, lawmakers, health innovators, and other health care stakeholders the information they need to make, or assist others in making informed decisions about health care purchases.”[1] Entities affected include most group health plans, including employer group health plans, and health insurance companies offering group and individual health coverage (“plans and issuers”). Additionally, the Final Rule makes certain changes to medical loss ratio (“MLR”) calculations,...