CMS Delays Enforcement of Key Parts of Price Transparency Rule by 6 Months

The Biden administration has delayed enforcement of key parts of a major insurer price transparency rule by six months until July 1, 2022, to give plans more time to comply.

The Centers for Medicare & Medicaid Services (CMS) announced the change in a new guidance released Friday focusing on the final price transparency rule released last October under the Trump administration. The guidance focuses on a requirement that certain health plans disclose online their in-network provider rates for covered items and services, out-of-network allowed amounts and billed charges for certain items and services.

The agency said it recognizes the “considerable time and effort required to make the machine-readable files available in the form and manner required in the [regulations].”

Even though the rule goes into effect Jan. 1, 2022, CMS will not enforce the requirement that plans publicly disclose their in-network, out-of-network amounts, and billed charges for plan years until July 1.

Any plan year that begins after July 1 must post the files in the “month in which the plan year (in the individual market, policy year) begins.”

Source: https://www.fiercehealthcare.com/payer/cms-delays-enforcement-key-parts-price-transparency-rule-by-six-months