As part of our commitment to improving the health care system, all Participation Agreements between UnitedHealthcare and health care professionals, medical groups, facilities and ancillary providers will be interpreted consistently with government-mandated price transparency and disclosure. This includes:
CMS Hospital Price Transparency Rule
The Centers for Medicare & Medicaid Services (CMS) Hospital Price Transparency Rule, effective Jan. 1, 2021, requires that hospitals publicly disclose the rates they negotiate with payers for all items and services, along with other pricing information, in a machine-readable file format.
Tri-Agency Health Plan Transparency in Coverage Rule
The Departments of Health and Human Services, Labor and Treasury finalized the Tri-Agency Health Plan Transparency in Coverage Rule that will require health plans and health insurance issuers in the Individual and Group Market (including Exchanges) to publicly disclose in-network negotiated rates, along with historical payments to and billed charges from out-of-network providers, along with otherdetailed pricing information, in a machine-readable file format.
Consolidated Appropriations Act, 2021 (CAA)
The Consolidated Appropriations Act, 2021 prohibits certain “gag clauses” in contracts with health care providers.