The Compliance Download, November Vol. 1

What New Price Transparency Rules Mean For You 

What’s the issue: The Treasury Department, IRS, Department of Labor, and Department of Health and Human Services have finalized new health plan price transparency regulations that align Transparency in Coverage requirements with the No Surprises Act. Beginning January 1, 2027, health plans and insurers must make cost sharing information available not only online and in paper form upon request, but also by phone. The rules also introduce significant changes to machine readable file (MRF) reporting, including new reporting structures, executive attestations, and additional data disclosure requirements.  

Why it matters: These rules expand compliance obligations and increase accountability for the accuracy of health plan pricing data. The requirement for enhanced reporting standards may increase governance, oversight, and documentation expectations for plan sponsors, carriers, and vendors.  

What to do: Review your current transparency compliance strategy with carriers, TPAs, and reporting vendors. Confirm who is responsible for maintaining machine readable files, validating pricing data, and meeting new disclosure requirements. 

Bottom line: Price transparency requirements are becoming more comprehensive and operationally complex. The fiduciary expectations of plan sponsors are expected to increase. Remaining up to date and proactive in data management will help you meet compliance requirements.  

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