Transparency in Coverage
What happened
Signed by Donald Trump, these final rules, effective December 7, 2026, amend existing regulations to enhance price transparency reporting for non-grandfathered group and individual health insurance coverage. They improve machine-readable files by adding data elements like product type and provider network, change data aggregation levels, and increase the reporting period for out-of-network historical data. Additionally, pricing information available online and on paper must now also be available by phone, satisfying requirements of section 114 of the No Surprises Act.
Why it matters
This policy aims to give patients clearer, more accurate pricing information, helping them make informed healthcare decisions. By standardizing and making pricing data more accessible, it intends to reduce surprise medical costs and potentially foster more competitive healthcare markets. This could lead to lower overall healthcare costs by empowering consumers.
Who it affects
- ›Non-grandfathered group health plans
- ›Health insurance issuers (group and individual)
- ›Patients seeking healthcare pricing information
- ›Grandfathered group health plans and issuers (for phone access)
- ›Healthcare industry regarding data reporting
The receipts are official. The summary is ours.
Read on Federal Register ↗Summaries are generated from the official text and may simplify or omit nuance. The official document is the source of truth.