Data / Federal rules / 2026-20447
Transparency in Coverage
The Health and Human Services Department published this final rule in the Federal Register on October 6, 2026. It takes effect on December 7, 2026.
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What the agency says
These final rules set forth requirements that 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 final rules are intended to improve the standardization, accuracy, and accessibility of public pricing disclosures in line with the goals of Executive Order 14221, "Making America Healthy Again by Empowering Patients With Clear, Accurate, and Actionable Healthcare Pricing Information." With respect to the In- network Rate and out-of-network Allowed Amount machine-readable files, these final rules aim to achieve these goals by adding new contextual files and additional data elements like product type, provider network name, and provider network identifier; 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 final rules also aim to improve the findability of all publicly disclosed machine-readable files required under the Transparency in Coverage rules, including the prescription drug file, by requiring a text file containing contact information for the files, and a footer with website URLs. These final rules also require pricing information that is made available through an online consumer tool and on 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 final rules).
Key facts
- Document number
- 2026-20447
- Type
- Final rule
- Action
- Final rule
- Agency
- Treasury Department; Internal Revenue Service; Labor Department; Employee Benefits Security Administration; Health and Human Services Department
- Published
- October 6, 2026
- Takes effect
- December 7, 2026
- Dates
- These regulations are effective on December 7, 2026.
- Docket
- TD 10058; CMS-9882-F
- Regulation ID (RIN)
- 0938-AV64; 1210-AC30; 1545-BR51
- 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
- 120
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 October 2026
Read from the Federal Register API, last updated 2026-10-23. The document on federalregister.gov is the official record; dates and dockets can change through later corrections. Free to reuse with credit to SpecStream under CC BY 4.0.