U.S. FEDRegulation
Federal agencies finalize health-plan price transparency rules effective Dec. 7
The Treasury, Labor and Health and Human Services departments issued final rules amending price-transparency reporting requirements for non-grandfathered group health plans and health insurance issuers. The rules add contextual data files and new data elements such as product type and provider network identifiers, change aggregation levels, expand out-of-network historical data, and require pricing information to be available by phone. The regulations take effect December 7, 2026.
Key points
- The final rules at 91 FR 63748 cover non-grandfathered group health plans and issuers of non-grandfathered group and individual coverage.Federal Register
- Adds contextual files with product type, provider network name, and network identifier.Federal Register
- Changes aggregation reporting level; drops in-network rates for unlikely provider-to-service mappings.Federal Register
- They lengthen the out-of-network reporting period, lower the claims threshold and reduce reporting cadence; they take effect December 7, 2026.Federal Register
- Plans must publish a text file with file contacts and URL footers to aid findability.Federal Register
- Pricing information must also be available by phone; this satisfies No Surprises Act section 114.Federal Register
Sources1 article across 1 outlet
Federal Register
Filed under
RegulationU.S.Federal Price Transparency Reporting Rules for Health Plans (2026 Final Rule)HealthcareInsuranceFor practitionersFor governance