On Nov. 17, 2021, the Departments of Labor (DOL)Health and Human Services (HHS) and the Treasury (Departments) released an interim final rule requiring health plans and issuers to report information regarding the cost of prescription drugs and certain medical expenses. This rule is a continuation of the Biden administration’s efforts to promote greater transparency in health care spending.

Plans and issuers were generally required to begin reporting by Dec. 27, 2021, and to submit information by June 1 of each year thereafter. However, the Departments delayed the reporting requirement for 2020 and 2021 information until Dec. 27, 2022.

This information will be used by the Departments to issue biennial public reports on prescription drug pricing trends and the impact of prescription drug costs on premiums and out-of-pocket costs starting in 2023.

See our bulletin below for details on this rule, including a list of the information that must be reported to the Departments annually.

Employer Action:
Employers with self-insured health plans should ensure that their TPA is preparing for timely compliance. Insurers will report information for fully-insured health plans. Stay tuned for additional guidance, including a reporting form with instructions and an internet portal for electronic reporting.

For recent Compliance Check blog posts, visit: https://www.valentgroup.com/category/employee-benefits/compliance-check/

This blog and its contents are not intended to be exhaustive nor should any discussion or opinions be construed as legal advice. Readers should contact legal counsel for legal advice.