Transparency in Coverage, 276 [2019-28290]

Agencies

• DEPARTMENT OF HEALTH AND HUMAN SERVICES

[Federal Register Volume 85, Number 2 (Friday, January 3, 2020)]
[Proposed Rules]
[Page 276]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2019-28290]



[[Page 276]]

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DEPARTMENT OF HEALTH AND HUMAN SERVICES

45 CFR Parts 147 and 158

[CMS-9915-N]
RIN 0938-AU04


Transparency in Coverage

AGENCY: Centers for Medicare & Medicaid Services, Department of Health 
and Human Services.

ACTION: Proposed rule; extension of comment period.

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SUMMARY: This document extends the comment period for the proposed rule 
entitled, ``Transparency in Coverage,'' that published in the November 
27, 2019, issue of the Federal Register. The comment period for the 
proposed rule, which would close on January 14, 2020, is extended 15 
days to January 29, 2020.

DATES: The comment period for the proposed rule published November 27, 
2019, at 84 FR 65464, is extended. To be assured consideration, 
comments must be received at one of the addresses provided below, no 
later than 5 p.m. on January 29, 2020.

ADDRESSES: Written comments may be submitted to the addresses specified 
below. Any comment that is submitted will be shared with the Department 
of the Treasury (Treasury Department), Internal Revenue Service (IRS) 
and the Department of Labor (DOL). Please do not submit duplicates.
    Comments, including mass comment submissions, must be submitted in 
one of the following three ways (choose only one of the ways listed):
    1. Electronically. You may submit electronic comments on this 
regulation to https://www.regulations.gov. Follow the ``Submit a 
comment'' instructions.
    2. By regular mail. You may mail written comments to the following 
address ONLY: Centers for Medicare & Medicaid Services, Department of 
Health and Human Services, Attention: CMS-9915-P, P.O. Box 8010, 
Baltimore, MD 21244-8010.
    Please allow sufficient time for mailed comments to be received 
before the close of the comment period.
    3. By express or overnight mail. You may send written comments to 
the following address ONLY: Centers for Medicare & Medicaid Services, 
Department of Health and Human Services, Attention: CMS-9915-P, Mail 
Stop C4-26-05, 7500 Security Boulevard, Baltimore, MD 21244-1850.
    For information on viewing public comments, see the beginning of 
the SUPPLEMENTARY INFORMATION section.

FOR FURTHER INFORMATION CONTACT: 
Deborah Bryant, Centers for Medicare and Medicaid Services, (301) 492-
4293
Christopher Dellana, Internal Revenue Service, (202) 317-5500
Matthew Litton or David Sydlik, Employee Benefits Security 
Administration, (202) 693-8335

    Customer Service Information: Individuals interested in obtaining 
information from the DOL concerning employment-based health coverage 
laws may call the Employee Benefits Security Administration (EBSA) 
Toll-Free Hotline at 1-866-444-EBSA (3272) or visit DOL's website 
(https://www.dol.gov/ebsa). In addition, information from HHS on private 
health insurance for consumers can be found on the Centers for Medicare 
& Medicaid Services (CMS) website (www.cms.gov/cciio) and information 
on health reform can be found at https://www.healthcare.gov.

SUPPLEMENTARY INFORMATION: All comments will be made available to the 
public. Warning: Do not include any personally identifiable information 
(such as name, address, or other contact information) or confidential 
business information that you do not want publicly disclosed. All 
comments are posted on the internet exactly as received, and can be 
retrieved by most internet search engines. No deletions, modifications, 
or redactions will be made to the comments received, as they are public 
records. Comments may be submitted anonymously.
    In commenting, please refer to file code CMS-9915-P. Because of 
staff and resource limitations, DOL, Department of Health and Human 
Services (HHS), and the Treasury Department (the Departments) cannot 
accept comments by facsimile (FAX) transmission.
    In the ``Transparency in Coverage'' proposed rule that published in 
the November 27, 2019 Federal Register (84 FR 65464), the Departments 
solicited public comments on proposals to implement legislative 
mandates under sections 1311(e)(3) of the Patient Protection and 
Affordable Care Act (PPACA) and section 2715A of the Public Health 
Service (PHS) Act. The proposed rules set forth proposed requirements 
for non-grandfathered group health plans and health insurance issuers 
offering non-grandfathered health insurance coverage in the individual 
and group markets to disclose cost-sharing information upon request, to 
a participant, beneficiary, or enrollee (or his or her authorized 
representative), including an estimate of such individual's cost-
sharing liability for covered items or services furnished by a 
particular provider. Under the proposed rules, plans and issuers would 
be required to make such information available on an internet website 
and, if requested, through non-internet means, thereby allowing a 
participant, beneficiary, or enrollee (or his or her authorized 
representative) to obtain an estimate and understanding of the 
individual's out-of-pocket expenses and effectively shop for items and 
services. The proposed rules also include proposals to require non-
grandfathered plans and issuers offering non-grandfathered health 
insurance coverage to disclose in-network provider negotiated rates and 
historical out-of-network allowed amounts through two machine-readable 
files posted on an internet website, thereby allowing the public to 
have access to information that can be used to understand health care 
pricing and potentially dampen the rise in health care spending. HHS 
also proposed amendments to its medical loss ratio program rules 
established under section 2718 of the PHS Act to allow issuers offering 
group or individual health insurance coverage to receive credit in 
their medical loss ratio calculations for savings they share with 
enrollees that result from the enrollee's shopping for, and receiving 
care from, lower-cost, higher-value providers. The comment period for 
the rule was scheduled to close on January 14, 2019.
    Since the publication in the Federal Register, there has been 
considerable interest expressed in the proposed rule, and some 
stakeholders have requested additional time to review and submit 
comments. The Departments value stakeholder feedback and want to gather 
as much information as possible as they consider whether and how to 
issue final rules. In response to these requests, the Departments are 
extending the period for submitting comments on the proposed rule to 
January 29, 2020.

    Dated: December 26, 2019.
Seema Verma,
Administrator, Centers for Medicare & Medicaid Services.
[FR Doc. 2019-28290 Filed 12-27-19; 4:15 pm]
 BILLING CODE 4120-01-P