Compliance News Week Ending March 7, 2025

In this Article

Executive Order - Pricing Transparency

Executive Order – Pricing Transparency

At the end of February, President Trump issued an Executive Order directing several federal agencies to further implement, enforce and possibly expand existing federal transparency regulations.

The existing transparency regulations require hospitals and health plans to, amongst other things:

publish machine readable files with pricing and reimbursement data; and

provide consumers with price comparison tools.

The hope is that further price transparency will help lower healthcare costs over time, but adoption of, and compliance with, the requirements has been slow. The new executive order does not make any immediate changes, but we are likely to see further action via regulations and potentially even new legislation, so it is something to watch.

For the most part, insurance carriers and TPAs handle these requirements on behalf of group health plans, so employers do not have much responsibility other than to confirm their service vendors are complying.

Level Funded and Self-funded plans should be talking to their carriers or TPAs to make sure they are complying with this transparency regulation.

^{While every effort has been taken in compiling this information to ensure that its contents are totally accurate, neither the publisher nor the author can accept liability for any inaccuracies or changed circumstances of any information herein or for the consequences of any reliance placed upon it. This publication is distributed on the understanding that the publisher is not engaged in rendering legal, accounting, or other professional advice or services. Readers should always seek professional advice before entering into any commitments.}