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CMS finalizes updates to price transparency regulations that aim to improve usability

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CMS finalizes updates to price transparency regulations that aim to improve usability

The Trump administration on Monday finalized a rule that aims to make the data files mandated under price transparency regulations more usable.

The Centers for Medicare & Medicaid Services said that the final rule will improve the data files made available by payers and providers by reducing duplicative information, adding further context about in-network pricing and holding stakeholders accountable for submitting incomplete or inaccurate data.

Under regulations finalized during the previous Trump era, both payers and providers are required to make publicly available data on negotiated prices for services. However, those files have often proven difficult to find and tend to be massive, making it far harder for the transparency data to be useful.

The rule would update reporting frequency to quarterly, rather than monthly, to ease administrative burden while requiring higher quality data. Insurers will also be required to provide personalized pricing information to members by phone, rather than just online.

CMS Administrator Mehmet Oz, M.D., said during an event hosted by the Department of Health and Human Services on Monday morning that "the changes are going to weed out redundancies, provide essential context, standardize how the data is going to get presented in ways that actually could be used by other parties."

"All this may seem pretty technocratic, but here's what's going to unleash very concretely: there's going to be an explosion of independent, innovative price transparency applications," Oz said. "There's going to be conversations with superintelligence and cost comparison tools."

We're going to give companies and patients the clearest picture yet on what they're actually paying for, and if it's the right value for them based on what their desires are," he said.


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