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Proposed Rule Requires Health Plans to Disclose Price and Cost-Sharing Information

November 15, 2019

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PRESS CONTACTS
Mary Mullaney, Director, Hospital Payment Policies

The Departments of Health and Human Services, Labor and Treasury Nov. 15 issued a proposed rule requiring health insurance plans to disclose price and cost-sharing information to patients enrolled in their plans.  Under the proposal, health plans would have to provide consumers with real-time access to personalized cost-sharing information, including an estimate of their cost-sharing liability for all covered health care items and services. 

The proposed rule would also require the disclosure on a public website health plans’ negotiated rates for in-network providers and allowed amounts paid for out-of-network providers

Lastly, the proposed rule seeks to encourage health insurance issuers to offer new or different plan designs that incentivize consumers to shop for services from lower-cost, higher-value providers by allowing issuers to take credit for “shared savings” payments in their medical loss ratio (MLR) calculations.

Comments on this proposed rule are due Jan. 15, 2020.

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