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This proposed rule would implement portions of Executive Order 13877 ("Improving Price and Quality Transparency in American Healthcare to Put Patients First,” June 24, 2019), which provides that the Secretaries of Health and Human Services, the Treasury, and Labor will increase transparency in cost sharing information under the Affordable Care Act.

Statement of Need:

This rule would propose requirements for health plans to provide consumers with some of the data necessary to effectively shop for health care items and services to make informed decisions.

Summary of the Legal Basis:

This rule addresses multiple sections of the Patient Protection and Affordable Care Act (Pub. L. 111-48) and the Health Care and Education Reconciliation Act of 2010 (Pub. L. 111-52), which amended and revised several provisions of the Patient Protection and Affordable Care Act.

Alternatives:

The proposed policies are important to provide transparency to consumers about the pricing of services. We considered variations on the proposed policies.

Anticipated Costs and Benefits:

We anticipate this regulation would be an economically significant action by the Tri-Departments under section 3(f) of Executive Order 12866.

Risks:

If this regulation is not published timely, important benefits for consumers could be delayed.