In a move similar to the amicus brief it filed in February 2020, the United States Chamber of Commerce has filed a lawsuit
against the U.S. Department of Health and Human Services' (HHS’s) Transparency in Coverage Rule
that requires health insurers to disclose the rates they negotiate with health care providers in a machine-readable format.
As covered in a past edition of The Valued Voice
, the U.S. Chamber joined WHA, the American Hospital Association and other hospital groups in February 2020 filing an amicus brief fighting the HHS rule requiring hospitals to disclose the rates they privately negotiate with health plans. A federal appeals court ruled against hospitals in a Dec. 29, 2020, ruling, paving the way for the rule to go into effect Jan. 1, 2021.
The Transparency in Coverage Rule for insurers is slightly different than the rule imposed on hospitals in that it requires insurers to provide a self-service tool for plan beneficiaries to obtain personalized out-of-pocket cost estimates for prospective care. That requirement begins with 500 services selected by HHS starting Jan. 1, 2023, and grows to include all services on Jan. 1, 2024. The requirement on making machine-readable files available goes into effect Jan. 1, 2022.
Rather than fighting the mandate for disclosing information to beneficiaries, the lawsuit focuses its challenge on the requirement of disclosing both rates privately negotiated with health plans and the historical net price of prescription drugs in a machine-readable format. The Chamber argues the administration lacks statutory authority to do this since the statute requires disclosure in plan-language, but the rule requires it to be read by a computer.
Additionally, the Chamber argues this requirement would also be "counterproductive, wasteful, and unlawful," saying, "These provisions of the rule threaten to reduce competition, and ultimately raise costs to consumers, by revealing confidential, commercially sensitive information that competitors currently do not share with each other." WHA noted similar concerns in its Price Transparency Rule comment letter
, citing the Federal Trade Commission's statements
that too much transparency can harm competition and consumers.
Contact WHA vice president of Federal and State Relations Jon Hoelter