Let's be
Rx Savings Solutions has been offering price transparency in the prescription drug market for more than a decade. It’s what we do.
Are you ready to address federal regulations aimed at giving consumers access to real-time healthcare costs—including drug pricing?
Our proven solution can help make sure you are.
The basics: New CMS Requirements
The Centers for Medicare and Medicaid Services (CMS) Transparency in Coverage (TiC) rule requires private insurers to post real-time cost-sharing information, out-of-pocket coverage rates and in-network drug pricing. In short, transparency is no longer voluntary. Penalties for non-compliance could be as high as $300 per plan participant per day.
NEW UPDATE: While enforcement of these new regulations may be delayed, here are some key dates to keep in mind:
Historical drug prices, in-network rates, out-of-network historic payments and billed charges must be made public.
Standard costs for an initial list of 500 medical items and services must be available in an internet-based self-service tool.
Costs for all covered services and prescription drugs must be available in an internet-based self-service tool.
Historical drug prices, in-network rates, out-of-network historic payments and billed charges must be made public.
Standard costs for an initial list of 500 medical items and services must be available in an internet-based self-service tool.
Costs for all covered services and prescription drugs must be available in an internet-based self-service tool.
What About
Medicare Advantage?
Effective January 2023, another CMS regulation (CMS-4190-F2) will require Part D plans to offer their beneficiaries access to a Real-Time Benefit Tool (RTBT). This comparison tool must allow enrollees to review options under their current prescription drug plan and give them the ability to choose lower-cost alternative therapies. Fortunately, our solution already meets these RTBT requirements.
ready for transparency rules?
Transparency Blog Series
Check out our ongoing blog series on price transparency to learn more about what these new regulations will mean to your organization.
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Delays or Not, Employers Should Still Prep for Transparency in Coverage
Despite enforcement delays, group health plans should keep moving toward price transparency. They have more to gain than compliance.
Why Transparency Matters
Aside from avoiding costly penalties, you may be asking: Why should I embrace price transparency? The answer really comes down to trust. By educating your members on all their medication options, you solidify your role as trusted partner. And with trust comes three key benefits:
Stronger
Engagement
Members become more active participants in their healthcare journey and are empowered to make better decisions.
Improved
Adherence
Lower-cost medications or treatments can lead to better medication adherence and improved health outcomes.
Member
Satisfaction
Healthier, happier members often translate to higher NPS scores and more positive survey results.
Looking Beyond Compliance
After more than 10 years helping our clients and members make sense of prescription drug pricing, we’ve learned that simply complying with regulations isn’t enough. Yes, RxSS technology creates the drug price transparency CMS is soon requiring. But we take that data a step further and share it with members in a way that empowers them to take action and take control of their out-of-pocket drug costs. Here’s how we do it:
Partner with health plans and employers to drive ROI.
Request a demo
We can talk about it and get deep into the weeds, but seeing is believing.
What you Can Expect
A clear picture of clinical strength, plan integration and a simple, intuitive user experience.
How easy it is for a member to save money for themselves and your plan.
Why Rx Savings Solutions blows away other so-called "savings tools."
