As you may be aware, the Consolidated Appropriations Act includes health plan price transparency regulations which helps consumers determine the cost of a covered item or service before receiving care.
Beginning July 1, 2022, most group health plans will be required to post pricing information for items and services. Machine Readable Files (MRF) will be linked on www.pbaclaims.com. This pricing information can be used by third parties, such as Providers.
More requirements will go into effect beginning January 1, 2023, which will provide additional access to pricing information for Plan members to have the ability to shop for the health care that best meet their needs.
PBA is partnering with an outside vendor to provide a Price Comparison tool for plan members by 1/1/2023. The Price Comparison tool will be integrated with www.pbaclaims.com to provide members a seamless online experience. Client and broker outreach on our new offering will begin soon to secure each clients intent and commitment to fulfill this Health Plan Sponsor requirement.
Please reach out to your Account Manager or Client Service Representative with questions. Thank you.”