David Schleifer

Technical Improvements Could Strengthen Transparency in Coverage Data Center grantee Simple Healthcare provides recommendations for improving TiC data that commercial health plans are required to release.

A new white paper from Simple Healthcare provides recommendations for improving the Transparency in Coverage (TiC) data that commercial health plans are required to release buff.ly/bn2ysET #healthcare #healthpolicy #healthecon

Center Responds to HHS, Treasury, and Labor Proposed Rule on Transparency in Coverage Data Reporting The Center offers recommendations to improve TiC data quality and reliability, expand file utility for employers, and strengthen compliance and enforcement.

The Depts of Health and Human Services, Treasury, Labor released a proposed rule to update Transparency in Coverage (TiC) data reporting requirements to make TiC data more usable. Check out the Peterson Center on Healthcare's response to the proposed rule buff.ly/RCvj2bg #healthcare #healthpolicy

States Move to Limit Access to H.I.V. Treatment

“The changes will have ripple effects… The cost of thousands of people losing their insurance will have to be absorbed by other parts of the public health system.

“This is really an economic disaster, a public health disaster, a moral disaster,” said Esteban Wood”

No Surprises Act system hits employer plans hard The average determination took 91 days and cost $445, and providers won 80% of the time.

"The No Surprises Act independent dispute resolution system is expensive, slow and usually favors the health care providers." buff.ly/T94GYvQ #healthcare #healthpolicy #healthecon

2026 Healthcare Price Transparency Forum - Program | Self-Insurance Institute of America, Inc. The Self-Insurance Institute of America, Inc. (SIIA) is a membership-based association that aims to protect and promote the interests of companies involved in the self-insurance/captive industry. Our…

I’m looking forward to the conversation about price transparency and fiduciary responsibilities at today’s SIIA conference buff.ly/p5z6Rnc #healthcare #healthecon #healthpolicy

Patients hit dead ends with insurance 'ghost networks.' Now, some are suing. A recent lawsuit is challenging one company, EmblemHealth, over its so-called ghost network of mental health providers.

Patients are suing insurers over 'ghost networks.' buff.ly/IlHzaeM. Research by
@publicagenda.bsky.social explores how challenges finding in-network #healthcare providers affect people's mental health, relationships, work, physical health, and finances buff.ly/B54i3ek #healthpolicy #healthecon

"Cancer treatment costs declined as much as 8.2% in cities where most hospitals published complete pricing data for oncology services." www.valueinhealthjournal.com/article/S109... #healthcare #healthecon #healthpolicy

Federal Register :: Request Access Due to aggressive automated scraping of FederalRegister.gov and eCFR.gov, programmatic access to these sites is limited to access to our extensive developer APIs. Please visit FederalRegister.gov API…

Departments of HHS, Labor, and Treasury extended the public comment period for the Transparency in Coverage (TiC) proposed rule to March 2, 2026. The rule can be accessed here: buff.ly/tsApCwF. The notice can be accessed here: buff.ly/vaHUgMh #healthcare #healthpolicy #healthecon

Report shows weak hospital and health plan price transparency across 10 US markets A recent report on health industry price transparency identified fees hidden from employers — raising questions on what else was concealed.

"Report shows weak hospital and health plan price transparency across 10 US markets"
buff.ly/ljP6SJU #healthcare #healthecon #healthpolicy

I'm looking forward to this conversation about health plan sponsors' and vendors' fiduciary duties at the Self-Insurance Institute of America's price transparency forum on Feb 26 www.siia.org/i4a/pages/in... #healthcare #healthpolicy #healthecon

www.siia.org/i4a/pages/in...

Screenshot of a quote from an anonymous NFL player who said, "I don't even know who Bad Bunny is. I always think it should be an American. I think they're trying too hard with this international stuff." The quote is from an anonymous survey of NFL players conducted by The Athletic.

Like this anonymous NFL player, many people don't know that Puerto Ricans are American citizens.

This new @pewresearch.org explainer answers common questions about Puerto Rico and its people: www.pewresearch.org/short-reads/...

"The cost of health care, not food or rent, is now Americans’ top worry," via @washingtonpost.com buff.ly/jDZwwxJ #healthcare #healthpolicy #healthecon

‘Transformative’ HIV PrEP shot slowly overcomes cost hurdles HIV/AIDS activists heralded the approval of a new twice-yearly pre-exposure prophylaxis (PrEP) medication last year, but these celebrations were tempered by insurers’ reluctance to …

HIV/AIDS activists heralded approval of a new twice-yearly pre-exposure prophylaxis (PrEP) medication last year, but these celebrations were tempered by insurers’ reluctance to cover its exorbitant cost. In the months since, payers are coming around, and more patients have access

Solomon says he's cutting heath care costs, will save Jersey City $30 million - New Jersey Globe Jersey City Mayor James Solomon is about to save the city $30 million while cutting health insurance costs for about 5,000 city employees and retirees by

Jersey City's new mayor is about to save the city $30 million while cutting #healthinsurance costs for about 5,000 city employees and retirees by roughly 8%. That's $30 million to spend on schools, transportation, and other priorities buff.ly/UVi5F7M #healthpolicy #healthecon #NewJersey #healthcare

Court rules pharmacies can pursue racketeering claims against major PBMs The list of defendants involved in the new ruling on the health plans' claims includes Sanofi, Eli Lilly and Novo Nordisk and the big PBMs — Optum Rx, Caremark and Express Scripts.

Court rules pharmacies can pursue racketeering claims against major PBMs
buff.ly/zfd6sGq #healthcare #healthpolicy

In December, Colorado was granted authority to monitor whether carriers are meeting state and federal TiC data rules, and issue penalties, fines, and other enforcement actions on carriers who are not compliant buff.ly/D1Jjxuj #healthcare #healthpolicy #healthecon

Transparency in Coverage Data to Expose Ghost Rates and Hold Payers Accountable: David Muhlestein, PhD | AJMC David Muhlestein, PhD, breaks down ghost rates, data gaps, and why stronger oversight is needed to make Transparency in Coverage files usable for patients.

On this episode of Managed Care Cast, AJMC spoke with David Muhlestein about his recent articles highlighting the completeness of Transparency in Coverage (TIC) files and ghost rates in TiC files buff.ly/J0W55Od #healthcare #healthpolicy #healthecon

Insurance CEO hearings: Bigwigs face Congress Thursday The chief executives of UnitedHealth Group, CVS Health, Elevance Health, Cigna and Ascendiun appear before Congress Thursday.

The CEOs of UnitedHealth, CVS, Elevance, Cigna and Blue Shield of California are testifying at two House committees today. Follow along with live updates from @mcauliff.bsky.social and @nonatc.bsky.social on @modernhealthcare.bsky.social (registration required but no paywall) bit.ly/4pO3apr

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"In 2022, 32BJ redesigned its health plan to exclude NYP from its network. That decision, in combination with benefit design strategies that incentivized members to go to lower-cost providers and centers of excellence, has saved 32BJ $200 million over four years."
buff.ly/1mY4gkf #healthcare

Florida proposes cutting eligibility for an AIDS drug program, causing panic In a surprise move, Florida officials have proposed drastically reducing eligibility for the state AIDS drug assistance program.

"Florida proposes cutting eligibility for an AIDS drug program, causing panic. The state would also eliminate coverage of two widely relied-on HIV medicines" buff.ly/qshn6Pw #healthcare #healthpolicy

State subjects health plan TPAs and PBMs to new licensing requirements Alaska lawmakers put a third-party administrator oversight provision in a pharmacy benefit manager bill.

A new law lets Alaska Division of Insurance license and supervise PBMs and TPAs, i.e. the "third-party administrators" that help employers' self-insured health plans and government health plans administer health benefits buff.ly/EyYIKAO #healthcare #healthpolicy #healthecon

You probably used quite a bit of January’s #LipidoftheMonth over the holidays, especially if you ate a lot of rich food.

lipidmaps.org/updates/lipi...

House GOP summons health insurance executives for hearing on affordability House Republicans on Thursday said they are summoning top health insurance executives to testify later this month as part of a series of hearings about health care affordability.  The move from the…

House Republicans said they are summoning top #healthinsurance executives to testify later this month as part of a series of hearings about #healthcare affordability
buff.ly/SumfQx7 #healthpolicy #healthecon

CivicaScript announces availability of low-cost insulin and biosimilar for chronic inflammatory conditions in the US | Civica Rx New additions expand company’s rapidly growing product portfolio

CivicaScript announces the availability of a low-cost insulin and a biosimilar for chronic inflammatory conditions in the US buff.ly/11hewBP #healthcare #healthpolicy #healthecon #pharma

WalletHub analyzed prices of 5 common #healthcare goods and services in 100 large US relative to median household income. Their 5 most expensive cities for the goods and services included in their analysis are Detroit, Cleveland, Newark, Toledo & Birmingham buff.ly/GGqNK10 #healthpolicy #healthecon

Here are the state healthcare laws taking effect in 2026 Several states are enacting laws related to prior authorization and private equity's role in healthcare.

Great summary of state laws governing #healthcare that are taking effect in 2026 buff.ly/KiXHF4P #healthpolicy

Employer health plan price data could get easier to use The Trump administration has drafted regulations aimed at making the transparency files fit in ordinary computers.

Health plan price data could get easier to use
www.benefitspro.com/2025/12/23/e... #healthcare #healthpolicy #healthecon

CMS proposes updates to insurer transparency requirements Proposed rule increases requirements for price comparison tools by aligning them with consumer protections established under the No Surprises Act.

CMS said TiC data “has been difficult to access due to oversized files, duplicative data, and information that could not be easily compared across the health insurance landscape“
www.healthcarefinancenews.com/news/cms-pro... #healthcare #healthpolicy #healthecon