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New Rule Requires Health Plans to Disclose Costs Up Front

New regulations designed to empower patients to become better consumers of health care and to help cut costs

New Rule Requires Health Plans to Disclose Costs Up Front

THURSDAY, Oct. 29, 2020 (HealthDay News) -- To make health care costs more transparent, the Trump administration will now require insurance companies to disclose actual prices for common tests and procedures, the Associated Press reported.

The new regulations on insurers are designed to empower patients to become better consumers of health care and to help cut costs. The requirements, however, would take effect over four years and patients will have to figure out how to make cost-versus-quality decisions about procedures like knee replacements or hernia repairs, the AP reported.

It is also not known what would happen to the policy if Trump is not reelected. Administration officials, however, say the changes will stand, saying that the goal of price transparency transcends political partisanship. "It will be impossible to walk backwards on this," Health and Human Services Secretary Alex Azar told the AP. "How do you fight transparency on prices? How do you actually articulate the argument that you should conceal what something costs from the person trying to purchase it?"

Insurance companies argue that the rules actually increase costs. Hospitals and doctors that now accept discounted rates will want to get paid more once they see what their competitors are getting, the AP reported. Most patients only find out what they owe after they leave the hospital and receive their "explanation of benefits" statement.

"We need to keep pricing on the front end, not the back end," Seema Verma, head of the Centers for Medicare & Medicaid Services, told the AP. "We have seen in every single industry that when this information is provided to consumers, it creates a new era of consumerism."

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