Updated on November 17, 2019
President Trump’s Pricing and Quality Transparency Executive Order (EO) was approved on November 15, 2019 and will go into effect January 1, 2021.
Challenges to the enforceability of these rules will be on-going so contact a Baker TIlly healthcare advisor to discuss your situation
Original article published on October 8, 2019
President Trump’s Pricing and Quality Transparency Executive Order (EO) signals a significant and much needed shift in the transparency of healthcare in the US.
Through mandated publishing of negotiated insurer rates with providers, the order moves to lift the veil surrounding true out-of-pocket costs associated with shoppable healthcare service(s), with an especially significant impact on those with private insurance. CMS moved quickly and issued a proposed rule based on President Trump’s EO that includes updating payment policies, payment rates and quality provisions for services under the Medicare Physician Fee Schedule (PFS) with a January 1, 2020 effective date.
In this guide, we outline key questions and strategic implications healthcare providers and health plans should be thinking of in the wake of pricing and quality transparency EO.