Policy & Regulation
CMS rulemaking, enforcement, No Surprises Act outcomes, and what's next for federal and state transparency mandates.
The Payer Files Get a Rewrite: What the Final Transparency in Coverage Rule Keeps, Cuts, and Starts
The final Transparency in Coverage rule keeps most of what CMS proposed in December, drops two proposed features, and adds an accuracy attestation tied to a named executive. The first rebuilt payer files are due April 1, 2027.
How Montana's state health plan climbed from near-insolvency to $112 million in reserves
Marilyn Bartlett took Montana's state employee health plan from near-insolvency to $112 million in reserves. She explains how employers can follow their healthcare dollars, from claims data to hospital costs.
How employers are taking control of healthcare costs in the modern benefits market
Jeff Hogan runs forensic reviews of employer health plan contracts. He explains where the money leaks, what fiduciary law now demands of plan sponsors, and the first moves a self-insured employer can make.
Unpacking the mechanics and award sizes of the IDR process
Actuary Tia Goss Sawhney unpacks the No Surprises Act's independent dispute resolution process: how qualifying payment amounts are set, why awards run so high, and what self-funded employers can do.
From a sketch to a rule: the origins of price transparency
Randy Pate helped write the federal price transparency rules at CMS. He walks through the original theory behind them, what the first pass got wrong, and what the data can accomplish for buyers today.
Welcome to The Price of Healthcare Podcast
Payerset co-founders Jerry DiMaso and Jacob Little on why they launched The Price Transparency Project, how the data has matured since 2022, and what to expect from the conversations ahead.
Updates to Hospital Price Transparency Requirements and the April 1st Enforcement Deadline
CMS replaced estimated allowed amounts with percentile-based remittance data in the hospital price transparency rule. Here's what changed before the April 1, 2026 enforcement deadline.
Transparency in Coverage (TiC) Schema 2.0 Is Live - Updates
February 2nd, 2026 marked the first enforcement deadline for TiC Schema 2.0. Here's what we're seeing on the ground with payer compliance and the new data fields.
CMS Proposes Major Updates to Transparency in Coverage (TiC) Rules
CMS is proposing significant updates to TiC requirements including network-based file structures, annual utilization files, quarterly reporting, and enhanced out-of-network data.
The market only works when prices are visible
Join the practitioners, policymakers, and advocates building a transparent healthcare system.