A proposed rule would require plans and issuers to disclose cost-sharing estimates to participants, as well as post in-network provider-negotiated rates and historical out-of-network allowed amounts on their websites. The rule would apply to group health plans and insurers in the individual and group markets and sponsors of self-insured group health plans. They would not apply to grandfathered plans. The Departments of Labor (DOL), Health and Human Services (HHS) and the Treasury (Departments) issued the rule.
The American Hospital Association and other hospital groups have filed a lawsuit in the U.S. District Court in Washington that claims the Centers for Medicare and Medicaid Services rule violates the First Amendment by provoking compelled speech and goes beyond the intended meaning of “standard charges” transparency in the Affordable Care Act.
Employee Benefit Advisors provides employee benefits, tax-advantaged healthcare, compliance guidance for ACA and Health & Welfare DOL Audits, and PEO Advisory & Consulting Services.