LEGAL ISSUES IN HEALTHCARE REGULATION AND COMPLIANCE

WEEK 1 2ND DQ HCS 430

Jennifer Noren

On October 29, 2020, the Department of Health and Human Services, the Department of Labor, and the Department of the Treasury released the Transparency in Coverage Final Rules that requires group health plans and health insurance issuers to disclose certain information – such as negotiated rates with providers, and estimated out-of-pocket expenses, to enable consumers to make informed health care decisions and know the costs that will be paid out of pocket and by their insurer.

I am on the workgroup that is implementing this final federal law. It is cumbersome. Given this, it is in the best interest of the consumer.

Here is a good summary of the rule – Summary – Transparency in Coverage

Additionally, hospitals have their own final federal rule relative to price transparency. This final rule was effective January 1, 2021.

Price Transparency – Relative to medical organizations

Do you see these rules as beneficial to the patient? What about the provider?

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