When a football game goes into overtime, it’s exciting, competitive, and generally applauded. But when enforcement of health insurer transparency goes into overtime, it’s frustrating, exhausting, and costly.
Per a recent Fierce Healthcare article, the Centers for Medicare & Medicaid Services (CMS) have given health insurers an extra six months to comply with a ruling to provide certain price transparency information.
The Trump administration’s price transparency rule was a two-parter:
Part One: Transparency in hospital pricing, which includes requirements for hospitals to disclose their standard charges, including negotiated rates with third-party payers.
Part Two: Transparency in insurance coverage, which requires that most group health plans and health insurance issuers disclose price and cost-sharing information to participants, beneficiaries, and enrollees.
While hospitals had to go live as of January 2020 (even though the final rule wasn’t published until October 2020), insurers had an extra 12 months to get their acts together, meaning, they had until January 2022. That is, until CMS extended the deadline again to July 1, 2022.
The reason for the extension? The agency said it recognizes the “considerable time and effort [that is] required to make the machine-readable files available in the form and manner required in the [regulations].”
As if it didn’t take substantial efforts for hospitals, too?
Just to be clear—both parts of the rule are intended to give consumers better insight into their healthcare costs. So why are regulators going so much easier on payors—the ones who don’t also have to save lives and deliver babies while figuring out how to keep the hospital lights on? Your guess is as good as ours, but we’re ready for this game to end.
