Data / Federal rules / 2025-23693
Transparency in Coverage
The Health and Human Services Department published this proposed rule in the Federal Register on December 23, 2025. Comments closed on February 23, 2026.
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What the agency says
These proposed rules set forth proposed requirements that would amend the 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. Specifically, these proposed rules would improve the standardization, accuracy, and accessibility of public pricing disclosures in line with the goals of the Executive Order 14221. With respect to the in-network rate and out-of-network allowed amount machine-readable files, these proposed rules would achieve these goals by adding new contextual files and additional data elements like product type, network name, and enrollment counts; changing the reporting level for aggregation of data; removing in-network rates for unlikely provider-to-service mappings; increasing the reporting period and lowering the claims threshold for out-of-network historical data; and reducing the reporting cadence. These proposed rules would also improve the findability of all of the publicly disclosed machine- readable files required under the Transparency in Coverage rules, including the prescription drug file, by requiring a text file and footer with website URLs and contact information for the files. These proposed rules would also require pricing information that is made available through an online consumer tool and paper (upon request), to also be made available by phone, and establish that the satisfaction of such requirement also satisfies the requirements of section 114 of the No Surprises Act (including for grandfathered group health plans and health insurance issuers offering grandfathered group and individual health insurance coverage that are not otherwise subject to these proposed rules).
Key facts
- Document number
- 2025-23693
- Type
- Proposed rule
- Action
- Proposed rule
- Agency
- Treasury Department; Internal Revenue Service; Labor Department; Employee Benefits Security Administration; Health and Human Services Department
- Published
- December 23, 2025
- Comments due
- February 23, 2026
- Dates
- To be assured consideration, comments must be received at one of the addresses provided below by February 23, 2026.
- Docket
- REG-107111-25; CMS-9882-P
- Regulation ID (RIN)
- 0938-AV64; 1210-AC30; 1545-BQ55
- Code of Federal Regulations
- 26 CFR 54; 29 CFR 2590; 45 CFR 147
- Topics
- Aged; Child support; Citizenship and naturalization; Civil rights; Employee benefit plans; Excise taxes; Health care; Health insurance; Individuals with disabilities; Infants and children; Intergovernmental relations; Maternal and child health; Penalties; Pensions; Privacy; Reporting and recordkeeping requirements; Sex discrimination
- Significant
- Yes, under Executive Order 12866
- Pages
- 87
Other documents from the Health and Human Services Department
Everything from the Health and Human Services Department · Rules on aged · Rules on child support · Rules on citizenship and naturalization · Published in December 2025
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