The U.S. Department of Health and Human Services (HHS) finalized new regulations on Monday aimed at making healthcare pricing and coverage information easier for patients to find, compare, and verify. The rules update existing Transparency in Coverage requirements and were issued through the Centers for Medicare & Medicaid Services in partnership with the Departments of Labor and the Treasury.
The new regulations require group health plans and insurers to reduce duplicative pricing data and provide more context around in-network prices. Reporting frequency for pricing information will shift from monthly to quarterly. Additionally, plans must provide consumers with personalized cost-sharing information by phone, in addition to existing online tools.
Officials emphasized that the goal is to ensure patients know what they will pay before receiving care. Robert F. Kennedy Jr., the U.S. Secretary of Health and Human Services, stated that President Donald Trump directed the agency to bring real price transparency to healthcare. CMS Administrator Dr. Mehmet Oz framed the rule around the principle that people should know their coverage and costs before receiving medical care.
The Departments intend to start developing an initial schema for a Prescription Drug File in November, with plans and issuers expected to publish using it starting December 2027. The rules build on an administration effort that has already pressed hundreds of hospitals to post accurate prices, with regulators warning of penalties up to $2 million annually for noncompliant facilities.
In after-hours trading, The Cigna Group Inc. (NYSE: CI) was down 0.085% to $271.06, UnitedHealth Group Inc. (NYSE: UNH) was down 0.16% to $377.97, and CVS Health Inc. (NYSE: CVS) was up 0.06% to $87.06.
