Executive Order Directing Departments to Issue New Guidance on Healthcare Pricing Information

April 1, 2025

Stephanie Hall, Associate Director, Benefits Compliance

On February 25, 2025, President Trump issued an executive order in an effort to “make more meaningful price information available to patients to support a more competitive innovative, affordable, and higher quality health care system.” Included in the executive order was a requirement for the Secretary of the Treasury, the Secretary of Labor and the Secretary of Health and Human Services (the “Departments”) to take prompt action to implement and enforce the healthcare price transparency regulations issued in 2020.

Employer Action Items

• Confirm Compliance Assuredness. Employers should check with their carriers and third party administrators (“TPAs”) to confirm whether they are complying with the current price transparency related rules and requirements.
• Inquire with Issuers and TPAs. Employers should ask carriers and TPAs what they are doing to monitor future guidance and any plans they are considering relative to the implementation of additional, novel transparency requirements.
• Monitor for Future Developments. Employers should monitor guidance as issued by the Departments.
• Monitor communications received by and from service providers related to transparency. Employers should closely monitor information requests and regulatorily imposed deadlines from their carriers and TPAs, as offered in response to future guidance that may be issued by the Departments concerning the healthcare pricing transparency policy debate.

Summary

President Trump issued an executive order in 2019 during his first term in office titled “Improving Price and Quality Transparency in American Healthcare to Put Patients First.” In response, the Departments issued a final rule in 2020 which imposed new transparency requirements on group health plans and health insurance issuers. The final rule required health plans and issuers to comply with the following price transparency related disclosures:

• Machine-readable files (“MRFs”): Health plans and issuers are required to disclose detailed pricing information in three MRFs on a public website. These MRFs provide information on negotiated rates for in-network providers, billed charges and allowed amounts from out-of-network providers and negotiated rates and prices for prescription drugs.
• Self-service price comparison tool: Health plans and issuers are required to make an internet-based self-service tool available to participants, beneficiaries and enrollees to disclose the personalized price and cost-sharing liability for covered items and services, including prescription drugs.

On February 25, 2025, President Trump issued an Executive Order signaling an effort to make more meaningful price information available to patients and to increase related enforcement efforts. Specifically included in the Executive Order was a requirement for the Departments to take the following actions within 90 days in order to implement and enforce the healthcare price transparency regulations issued in 2020:

• Require the disclosure of actual prices and items of services, not estimates;
• Issue updated guidance or proposed regulations ensuring pricing information is standardized and easily comparable; and
• Issue guidance or proposed regulations updating enforcement policies designed to ensure compliance with the transparent reporting of complete, accurate and meaningful data.

This executive order is a clear indication that the Trump administration has a renewed focus on transparency in healthcare pricing and employers as plan sponsors should take note of upcoming expanded disclosure requirements or risk more stringent enforcement. 

Additional Information & Resources

• Executive Order dated February 25, 2025 (Making America Health Again by Empowering Patients with Clear, Accurate, and Actionable Healthcare Pricing Information)
• Final Rule