Transparency in Coverage

Transparency in Coverage These final rules set forth requirements that amend the regulations under the Public Health Service Act, the Employee Retirement Income Security Act of 1974, and the Internal Revenue Code regarding price transparency reporting requirements for non- grandfathered group health plans and health insurance issuers offering non-grandfathered group and individual health insurance coverage. Specifically, these final rules are intended to improve the standardization, accuracy, and accessibility of public pricing disclosures in line with the goals of Executive Order 14221, "Making America Healthy Again by Empowering Patients With Clear, Accurate, and Actionable Healthcare Pricing Information." With respect to the In- network Rate and out-of-network Allowed Amount machine-readable files, these final rules aim to achieve these goals by adding new contextual files and additional data elements like product type, provider network name, and provider network identifier; changing the reporting level for aggregation of data; removing in-network rates for unlikely provider- to-service mappings; increasing the reporting period and lowering the claims threshold for out-of-network historical data; and re Agency: Treasury Department, Internal Revenue Service, Labor Department, Employee Benefits Security Administration, Health and Human Services Department. Document type: Rule. Document number: 2026-20447. Official Federal Register document. Matter furnished by the National Archives Federal Register API. Notice Nearby is not the publisher of record for this item. Source: https://www.federalregister.gov/documents/2026/10/06/2026-20447/transparency-in-coverage