HR Policy Submits Comments Supporting Rule to Increase Health Care Price and Quality Transparency

January 31, 2020

HR Policy Association and our American Health Policy Institute told the U.S. Department of Health and Human Services that “market-based solutions cannot work to address the health care cost and quality problems in the United States without a degree of transparency that far exceeds what is available today.”

The proposed Transparency in Coverage rule would require employers, insurers, and their third-party administrators to:

  • Make available to plan participants personalized out-of-pocket cost information for all covered health care items and services through an internet-based self-service tool and in paper form upon request; and

  • Make available to the public, including stakeholders such as consumers, researchers, employers, and third-party developers, the in-network negotiated health provider rates and historical payments of allowed amounts to out-of-network providers through standardized, regularly updated machine-readable files.

Our comments made a number of recommendations to reduce implementation costs and protect employers, including:

  • Phasing in the disclosure requirements over two or three years;

  • Simplifying the overly-prescriptive internet-based self-service tool; and

  • Improving the safe harbor protections for employer plans.

AHPI weighs in on quality data:  The comments also noted that while employers should be encouraged to provide quality data, much more needs to be done on simplifying and developing standardized quality measures before requiring employers to disclose the data.

Next step for the rulemaking:  The Departments of Health and Human Services, Treasury, and Labor will now review the comments before publishing a final rule later this year.  The final rule, which may be challenged in court, is likely go into effect one year later (2022).