Will the Transparency in Coverage Rule Impact You?

The Transparency in Coverage final rule released by the Department of Health and Human Services (HHS), the Department of Labor, and the Department of Treasury puts health care information in the hands of consumers and has the potential to impact all healthcare providers.

We can help your practice stay on top of the latest healthcare news, rules, regulations and trends.  Subscribe to stay current and up to date on important matters that will impact your practice.  (To subscribe to our blog click here).

The rule was a result of President Trump’s executive order on Improving Price and Quality Transparency in American Healthcare to Put Patients First.

Under the rule, hospitals must disclose standard charges, including negotiated rates with third-party payors.

Under a previous rule, hospitals are expected to start sharing their prices in January.

Under this rule, employer health plans and insurance companies will be required to post in-network and out-of-network rates they negotiate with providers. They will also need to share how much they are willing to pay out-of-network physicians.

Insurers will need to disclose cost-sharing estimates and will need to develop online price transparency tools.

While the impact is yet to be seen, the goal is to boost competition among hospitals and insurers to drive down healthcare costs. Patients will be able to see their costs prior to receiving treatment, and in theory, will be able to shop around.

Hospitals and physicians have voiced opposition, as they are worried about their administrative costs. Others have asked that quality metrics also be posted, in addition to costs.

Have you read the final rule? Let us know what your thoughts are by commenting below!

In our next blog post, we will keep you informed of related issues.  To get this important information delivered directly to your mail box, click here to Subscribe.

Do you need help staying current and compliant with the latest laws, rules and regulations?  We can help. To contact us about your new government rules and regulations, your practice’s risk assessment, or about your other legal needs:  CLICK HERE.

Leave a Reply

Your email address will not be published. Required fields are marked *

This site uses Akismet to reduce spam. Learn how your comment data is processed.