Two top senators are urging the Biden administration to address “loopholes” that they said allow insurers to skirt price transparency requirements.
Sens. Maggie Hassan, D-New Hampshire, and Mike Braun, R-Indiana, wrote in a letter (PDF) to Centers for Medicare & Medicaid Services Administrator Chiquita Brooks-LaSure that the agency should update its regulations to “ensure that there is true health plan transparency and compliance.”
The senators said some insurers have posted the required data in “an indecipherable structure” or made the files so large that they can only be processed by a supercomputer. This technically meets the requirement of posting the data but makes the information extremely difficult to use.
“As a result, employers and researchers have been unable to use the data to assess the drivers of high health care costs and target solutions,” they wrote.
The letter noted that public policy experts have suggested multiple avenues CMS could take to mitigate these loopholes, including setting file size limits, creating a standardized template for reporting, requiring a clear organization system with labels and reducing reporting frequency.
The senators said these changes would make the data more readily usable but would also streamline reporting requirements for insurers.
In addition, the agency should pair these reforms with stepped-up enforcement of requirements, holding plans that post low-quality data—or no data at all—more accountable.
“Randomly auditing the quality of plan data would result in better usability, and additional enforcement would help ensure that remaining noncompliant plans follow the law,” the senators wrote. “We urge CMS to consider these and other expert recommendations so we may continue improving price transparency for Americans and ultimately bring down health care costs.”