Advancements in Health Care Price Transparency Regulations

U.S. Administration Advances Health Care Price Transparency Enhancements

The Centers for Medicare & Medicaid Services (CMS), in collaboration with the Department of Labor and the Department of the Treasury, is proposing enhancements to health care price transparency regulations. Launched in 2020, these regulations aim to uncover the once hidden costs of health care services, providing employers, researchers, and other stakeholders with essential pricing data. This initiative targets the enhancement of regulatory compliance requirements and promotes broader access to critical health care cost information across the industry.

The current proposal seeks to simplify the data format for transparency as the previous version was criticized for being overly complex. By restructuring the data and eliminating redundancies, the new rules are set to make pricing information more accessible and usable across the health care industry. This approach is expected to foster competition and innovation, enabling organizations, even those with limited technical capabilities, to benefit from detailed insight into health care costs.

Enhancing Consumer Tools and Standardizing Cost-Information

Aligned with Executive Order 14221, the proposal emphasizes enhancing consumer-facing cost tools and standardizing price disclosure requirements. These improvements are designed to offer consumers precise, personalized price estimations, complementing the No Surprises Act and providing comprehensive protection from unexpected medical billing. The proposal also outlines a detailed framework for group health plans and insurance issuers to deliver uniform cost-sharing information via online, print, and phone, facilitating informed consumer decisions regardless of digital literacy or internet access.

Although prescription drug price disclosures are not currently addressed, there are plans to tackle this area separately. The administration encourages stakeholders to submit feedback on the proposed regulations, particularly focusing on achieving further standardization and reducing administrative burdens. The deadline for public comments is set for February 21, 2026.

Stakeholders can view the proposed rule and its related materials on the Federal Register and CMS websites. This initiative aims to transform the health care pricing landscape, improving negotiations and empowering consumers with informed choices.