For providers, more accurate and consistently organized payer pricing data could sharpen contract benchmarking and strengthen rate negotiations.
The 60-day comment period — closing February 23, 2026 — is an opportunity for provider organizations to weigh in on how these reforms affect the usability of pricing data in post-acute and long-term care contracting.
The 2020 Transparency in Coverage rules led to the historic release of pricing information, allowing employers, researchers, and the broader public to learn critical details about the costs of health care. However, the Transparency in Coverage data has been difficult to access and navigate. Oversized files, duplicative data, and information that could not be easily compared across the health insurance landscape has limited its use and reliability. The Departments’ proposals would directly confront these barriers by simplifying how data is organized, eliminating unnecessary information, and making consumer-facing cost tools more accessible to more consumers.
— CMS.gov, December 19, 2025
Centers for Medicare & Medicaid Services. “Trump Administration Proposes Significant Updates to Disclosure Requirements to Make Health Care Prices Clear, Accurate, and Actionable for Americans.” CMS.gov, 19 Dec. 2025. https://www.cms.gov/newsroom/press-releases/trump-administration-proposes-significant-updates-disclosure-requirements-make-health-care-prices.
CMS proposes new price transparency rules
The 2020 Transparency in Coverage rules marked President Trump’s first major effort to require health insurance companies to release detailed healthcare pricing information to the public, but the data has been difficult for employers, the broader public and researchers to navigate and access. The new updates would address this by requiring health plans and insurers to simplify how they organize data, making consumer-facing cost tools more easily accessible and cutting unnecessary information.
— Becker’s Hospital Review, December 19, 2025
2025 Transparency in Coverage proposed rule released
Notably, the proposed rule also moves payers from a monthly file refresh requirement to a quarterly file refresh. Hospitals are currently required to update their files annually. These changes, if finalized and implemented, would likely significantly decrease the amount of MRF data users would need to download and parse, thus making the experience more nimble.
— Turquoise Health, December 19, 2025
Transparency in Coverage Proposed Rule Summary
On December 23, 2025, the Departments of Labor, Health and Human Services, and the Treasury (collectively, the Departments) published in the Federal Register (90 FR 60432) a proposed rule that updates the Transparency in Coverage regulations under the Public Health Service Act, the Employee Retirement Income Security Act of 1974, and the Internal Revenue Code regarding price transparency reporting requirements for non-grandfathered group health plans and health insurance issuers offering non-grandfathered group and individual health insurance coverage
— HFMA, January 6, 2026
✔ Comply with every payer's rules
✔ Equip your team with the Playbook
✔ Monitor rates and payer trends
