Final transparency in coverage rule released

On Oct. 5, the Trump Administration released a Transparency in Coverage (TiC) final rule to amend certain price transparency reporting requirements of the 2020 TiC rules. The Administration said the new rule would facilitate better accessibility, less ambiguity, and increased alignment with transparency rules for hospitals.

The rule adds new obligations, including a senior executive attestation to the accuracy and completeness of each file, posting of three new contextual files, and expands out-of-network reporting. The Administration did not finalize its proposal to require posting of change-log files and enrollment numbers, which the industry had opposed. The Administration also accelerated the implementation timeframe, requiring compliance for portions of the final rule within only five months, even though key implementation guidance is not yet available. Government Affairs is assessing operational impacts with the business, including the accelerated implementation timeframe.

The Departments also indicated their intent to begin developing the prescription drug schema next month, with plans to publish a rule by May 2027, and enforce it by the end of 2027. Separately, Federal Trade Commission (FTC) Chairman Andrew Ferguson sent letters to 24 of the largest for-profit hospital groups to inform them of their legal obligation under the FTC Act to provide truthful and accurate pricing information to customers. Ferguson asserted that patients are entitled to complete and accurate pricing information offered ahead of rendering services, and hospitals that fail to do so will be taken to court.