Affordable Care Act (ACA): Price Transparency Requirements | Practical Law

Affordable Care Act (ACA): Price Transparency Requirements | Practical Law

Under the Affordable Care Act (ACA), as implemented, employer-sponsored health plans must satisfy certain disclosure and reporting requirements relating to price transparency. Plans must publicly post on a website, and update on a monthly basis, three machine-readable files that separately include: (1) in-network rates with health providers for all covered services; (2) out-of-network allowed amounts and billed charges for covered services; and (3) negotiated rates and historical net prices for covered prescription drugs. (Section 2715A of the Public Health Service Act (PHSA) (42 U.S.C. § 300gg-15a).) The ACA's price transparency requirements apply to large group, small group, and self-funded plans. This video provides an overview of the ACA's price transparency requirements.

Affordable Care Act (ACA): Price Transparency Requirements

Practical Law US Video and Audio w-039-7513 (Approx. 4 pages)

Affordable Care Act (ACA): Price Transparency Requirements

by Practical Law Employee Benefits & Executive Compensation.
Law stated as of 14 Jun 2023USA (National/Federal)
Under the Affordable Care Act (ACA), as implemented, employer-sponsored health plans must satisfy certain disclosure and reporting requirements relating to price transparency. Plans must publicly post on a website, and update on a monthly basis, three machine-readable files that separately include: (1) in-network rates with health providers for all covered services; (2) out-of-network allowed amounts and billed charges for covered services; and (3) negotiated rates and historical net prices for covered prescription drugs. (Section 2715A of the Public Health Service Act (PHSA) (42 U.S.C. § 300gg-15a).) The ACA's price transparency requirements apply to large group, small group, and self-funded plans. This video provides an overview of the ACA's price transparency requirements.