The purpose of this outline is to provide you with a snapshot of how different carriers are complying with the CCA regulations that were just passed. This does not address the broker pricing transparency portion of the law, just the carrier/member requirements.

• No Surprises Rule – The No Surprises Rules prohibit the provider from balance billing an individual, even if the provider views the amount paid by the health plan as inadequate for the service rendered. This provision of the CAA was in effect on Jan 1, 2022. ^[1]
• Under Phase One of the new rules, health plans must publicly post machine-readable files for in-network rates, out-of-network allowed amounts and billed charges, and prescription drug negotiated rates (prescription delayed indefinitely) and historical prices. These Phase One transparency regulations apply to plan years beginning on or after January 1, 2022. – Delayed until Jul 1, 2022
• In Phase Two, health plans must provide an internet service tool that supplies information relevant to their costs for 500 specified items and services. The tool must allow for searching by billing codes, descriptive terms, and in-network providers. Enrollees must be able to refine and reorder their search by geography and the amount of cost-sharing responsibility. Phase Two applies to plan years beginning on or after January 1, 2023.
• Phase Three extends Phase Two to all items and services, and applies to plan years beginning on or after January 1, 2024.^[2]

^[1]CLICK HERE

^[2]CLICK HERE