CMS Finalizes Overhauled Price Transparency Rules for Payers
CMS, along with the Labor and Treasury departments, finalized a rule overhauling price transparency requirements for health plans and self-insured employers, revising regulations first established in 2020. The rule eliminates so-called "ghost rates" for services providers rarely perform, consolidates in-network rate files by provider network rather than by plan, lowers the claims threshold for reporting out-of-network allowed amounts, and requires a named executive to attest to data accuracy. The rule takes effect Dec. 5, 2026, with most data requirements phased in through 2027, including attestation and file changes by March 2027 and taxonomy/utilization file requirements by September 2027. Regulators declined to require consumer-friendly cost summaries or a "what changed" file, citing limits on reflecting individual cost-sharing.