Price Transparency Rules for Health Plans: Key Issues for Plan Sponsors, Service Providers, and Insurers
Requirements and Recent Mandates, Administrative and Operational Challenges, and Next Steps to Promote Compliance
Recording of a 90-minute premium CLE video webinar with Q&A
This CLE course will guide employee benefits attorneys, plan sponsors, and plan administrators and service providers through new price transparency rules for health plans. The panel will discuss key provisions of the final rule; the rule's impact on plan sponsors, insurers, and service providers; requirements and new mandates; administrative and operational challenges; and best practices to promote compliance.
Outline
- Key provisions of the price transparency rules
- Application of disclosure requirements to health plans
- Disclosure of cost-sharing information
- Disclosure of negotiated in-network and out-of-network rates
- Shared savings in the medical loss ratio
- Best practices and next steps for plan sponsors, insurers, and service providers
Benefits
The panel will review these and other key issues:
- What are the key provisions of the price transparency rules?
- How do the rules impact health plan sponsors, insurers, and service providers?
- What are the disclosure requirements for cost-sharing, in-network rates, out-of-network amounts, and shared savings?
- What potential shared savings are available under the revised MLR regulations?
- What are the next steps and best practices to maintain compliance with the new rules?
Faculty
Margaux J. Hall
Partner
Ropes & Gray
Ms. Hall is a leading lawyer in drug pricing, managed care and value-based payment arrangements. She brings to clients... | Read More
Ms. Hall is a leading lawyer in drug pricing, managed care and value-based payment arrangements. She brings to clients an understanding of the transformative legal and policy issues affecting pharmaceutical manufacturers, and the life sciences and health care sectors more broadly.
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William O. Williams, II
Insurance Regulation Practice Group Leader
Frost Brown Todd
Mr. Williams practices administrative and regulatory law in the areas of insurance and health care, representing health... | Read More
Mr. Williams practices administrative and regulatory law in the areas of insurance and health care, representing health insurance and health care companies. With more than 22 years of in-house experience at one of America’s largest health care companies, he has advised licensed and risk-bearing entities in administrative, regulatory, and enforcement matters before state and federal agencies. Mr. Williams managed major in-house law department functions supporting commercial health insurance, Medicare, and Medicaid products and operations, and has extensive knowledge and experience resolving complex legal, regulatory and operational problems for his clients. He works closely to understand their business, providing legal advice that helps them achieve their goals and objectives in an ever-changing legal and regulatory environment. Mr. Williams leads Frost Brown Todd’s Insurance Regulation Practice Group and is a member of the firm’s Insurance Industry Team and Health Care Innovation Team. He is AV rated by Martindale-Hubbell, and a member of the Federation of Regulatory Counsel (FORC) and of the American Health Law Association (AHLA).
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