Transparency Reporting and Compliance Rules for Group Health Plans


Summary

This practice note describes new reporting and other requirements for employer group health plans enacted under the No Surprises Act and other provisions of the Consolidated Appropriations Act, 2021 (CAA) (Pub. L. No. 116-260). The reporting measures require affected entities to provide substantial amounts of information to oversight agencies to help the agencies, lawmakers, and other stakeholders better understand the factors driving prescription drug and other health care coverage costs as well as to help assess broader trends in the health care market and the effectiveness of transparency and balance billing reforms under the CAA and Patient Protection and Affordable Care Act (ACA) rulemaking. Other rules attempt to enhance the transparency of the health care market, particularly as it relates to health plans and health insurance providers' contractual relationships with third-party service providers to give stakeholders a more accurate view of market costs and pricing.