New Rule Requires U.S. Hospitals and Insurers to Publicly Disclose Cost Information

Effective January 11, 2021, the Trump administration’s Transparency in Coverage rule will require U.S. hospitals to publicly post their prices for each service they offer, itemized by component and procedure.

In addition, the final rule requires insurance plans and issuers to disclose in-network provider negotiated rates, historical out-of-network allowed amounts, and drug pricing information via three files posted on a publicly accessible website. The rule’s intent is to avoid surprise medical bills and lower health care costs by allowing patients to take price into consideration when “shopping” for providers.

“In every other marketplace in our economy, the consumers benefited from competition. So when hospitals have to compete for our hard-earned dollars, [we as consumers will] shop with our feet to get the best quality of care at the lowest possible price. Think about it. Why didn’t we know prices in health care? It’s almost absurd. And now that’s over,” Cynthia Fisher, founder and chair of PatientsRightsAdvocate.org who worked with the Trump administration on the new rule, told NPR in an interview.

Sources: NPR, January 2, 2021; Federal Register, November 12, 2020.