For Immediate Release
Washington, DC – The ERISA Industry Committee (ERIC) filed comments today on the Department of Health and Human Services’ (HHS) proposed regulations relating to transparency in health coverage. The regulations would require health plans and health insurance issuers to disclose of out-of-pocket costs and negotiated rates.
ERIC fully supports efforts to increase the transparency of medical prices, and believes that employers should be able to rely on their trusted partners such as insurance carriers and third-party administrators (TPAs) to inform their plan beneficiaries about the rates they negotiate with providers on the employers’ behalf.
“Transparency drives competition among health care providers, and helps patients make informed decisions – both of which reduce health care costs and to improve the quality of care,” said James Gelfand, Senior Vice President of Health Policy. “ERIC member companies continue to cope with health care costs that rise at an unsustainable rate, and we believe that disruption is critical in order to change this dynamic.”
In regards, to HHS’s proposed regulations, ERIC’s comments included:
- The departments have the authority to develop and issue regulations to drive transparency in health care
- All plan beneficiaries, whether in high-deductible health plans (HDHPs) or other types of plans, must be equipped with information to help them more efficiently utilize health care, and to access low-cost, high-value medical items and services
- Transparency will lower health care costs
- Transparency rules need not increase the threat of litigation for plan sponsors
- Price fixing and sharing of trade secrets would not happen if the proposed regulations were enacted, due to antitrust laws
- There’s a need to create protections, such as a safe harbor, for plan sponsors that cannot gain access to the necessary information – as well to ban gag clauses, and transfer liability as appropriate to service providers
- Transparency could reduce surprise medical bills, but would require disclosures by hospitals
Additionally, ERIC’s comments focused on the delivery and sharing of information:
- ERIC is supportive of requirements for an online cost-sharing tool that will equip participants with the most accurate, customized cost-sharing information, but the proposed requirements need to be implemented in a cost-effective way
- ERIC believes using paper to deliver benefits information is outdated; plans and carriers should be permitted to deliver the cost-sharing liability information to participants through a mobile application as well as a website
- ERIC supports the use of a publicly accessible standards-based application program interface (API) developed and maintained by HHS
- ERIC called for HHS to delay the effective date of the regulations and implement a gradual transition to allow for plan sponsors to address any technical difficulties they may experience during the transition
ERIC also encouraged the Departments explore how quality measures and benchmarks can be integrated with the proposed regulation.
“ERIC understands the Departments are focused on cost as the first step in moving toward transparency, but we believe that quality transparency is an equally important piece of the puzzle, and that they must work toward a system in which patients are empowered with both cost and quality data,” said Gelfand.