President Donald Trump’s administration proposed significant updates Dec. 19 to healthcare price transparency rules to help make costs more “clear, accurate and actionable for Americans.” The proposal, shared by CMS, in partnership with the labor and the treasury departments, builds on rules established during President Trump’s first term.
“Americans have a right to know what healthcare costs before they pay for it,” HHS Secretary Robert F. Kennedy Jr., said in a Dec. 19 news release. “This proposal delivers real transparency by turning hidden pricing into clear, usable information — so families can make informed decisions and hold the system accountable.”
The 2020 Transparency in Coverage rules marked President Trump’s first major effort to require health insurance companies to release detailed healthcare pricing information to the public, but the data has been difficult for employers, the broader public and researchers to navigate and access. The new updates would address this by requiring health plans and insurers to simplify how they organize data, making consumer-facing cost tools more easily accessible and cutting unnecessary information.
Some of the suggested improvements, which mainly apply to health plans and insurers, feature excluding unlikely services from in-network rate files, adding change-log and utilization files to improve tracking, reorganizing files by provider network to cut back on redundancy, reducing reporting frequency from monthly to quarterly and growing out-of-network pricing data with longer reporting periods and lower claims thresholds.
Price comparison tools are also strengthened under the proposed rule, requiring issuers to provide detailed, consistent cost-sharing information by phone, in print and online. The No Surprises Act would have updated disclosures reflect protections to help patients know their rights and potential financial responsibilities.
Major changes to prescription drug disclosure requirements are not included in the proposed rule, which the department plans to separately address.
Feedback can be submitted by stakeholders on the proposed rule during a 60-day comment period, which ends Feb. 21.
“Every person deserves to know what their health care will cost without needing a team of analysts to decode it,” CMS Administrator Mehmet Oz, MD, said in the release. “This overhaul takes a giant step toward that effort. By delivering clearer, more reliable pricing information, we are empowering Americans to take control of their care and creating a more competitive and affordable health system in the process.”
