October 8, 2026

The final rule addresses gaps in existing price transparency requirements by removing unnecessary data, standardizing file formats, and increasing accountability for insurers. In a statement, CMS Administrator Dr. Mehmet Oz emphasized that consumers should understand what their insurance covers and what they may owe before receiving care, rather than after a bill arrives. The rule also requires insurers to report most in-network negotiated rates as dollar amounts instead of percentages or other estimates, making the data easier for consumers, employers, and other stakeholders to interpret and compare.

Texas Attorney General Ken Paxton has launched an investigation into UnitedHealth over allegations that the insurer used deceptive or unlawful practices to deny or delay medically necessary care. The investigation will examine potential violations of the Texas Deceptive Trade Practices Act and other state laws, including allegations that UnitedHealth overrode physicians’ medical judgment and, in some cases, reversed prior authorization decisions after care had already been provided. Paxton’s office has issued civil investigative demands seeking evidence from the company.

Independence Blue Cross agreed to pay $22.5 million to settle allegations that it improperly submitted inflated diagnosis codes in Medicare Advantage, resulting in higher Medicare payments. The case highlights ongoing scrutiny of risk adjustment and upcoding practices, particularly insurers’ responsibility to validate diagnoses used to support MA payments.

The Trump administration is providing a one-time $90 payment to 20.8 million eligible traditional Medicare beneficiaries to offset their 2026 Part B premiums. The rebate excludes Medicare Advantage enrollees. Higher-income beneficiaries, and those receiving Medicaid premium assistance.

This sponsored article highlights how a shared, multi-state provider data platform could reduce duplication, streamline credentialing, and strengthen Medicaid provider network management while preserving state data ownership.