Alexis Boaz, Associate in the Health Care & Life Sciences practice, in the firm’s Washington, DC, office, was quoted in Bloomberg Law Health Law & Business, in “Medical Price Transparency Rule Simplifies Data, Excludes Drugs,” By Lauren Clason. (Read the full version- subscription required)
Following is an excerpt:
Price transparency advocates say a recent health insurance proposal from the Trump administration will improve insights into medical rates, even as it punted on implementing delayed rules around drug price transparency. …
Researchers and advocates said the biggest improvement in the proposed rule is the elimination of “ghost rates”—contracted prices for services that a particular specialist doesn’t typically provide. The departments noted that a September 2024 analysis found that 73% of hematologists’ rates were for 500 billing codes they were unlikely to use. …
The proposal also reduces the administrative burden on insurers, said Alexis Boaz, an associate with Epstein Becker & Green PC.
“That’ll make it much easier for issuers who are submitting on behalf of a lot of different types of plans,” she said.
Several other reporting requirements, such as enrollment figures and plan types, aim to build context around the numbers. The rule also would require insurers to explicitly identify new information in data updates, as well as to standardize the location of the files on their websites.
