Health Affairs September 19, 2023
Starting on July 1, 2022, group health plans and health insurance issuers are required by the Transparency in Coverage (TiC) rule to release machine-readable data files containing in-network negotiated rates for all covered items and services, for all providers with which they contract. This is the analogue to the Hospital Price Transparency rule, which, since January 1, 2021, has required hospitals to post machine-readable data files containing the “standard charges” for all items and services they provide.
While regulators have high hopes for the potential of these payer price transparency data to stimulate market forces and thus contain costs, compliance with the TiC rule is a necessary first step to this important goal. Should payers fail to provide the required...
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