provider (identified by national pro-
vider identifier), other than items and 
services with respect to which fewer 
than 20 claims for such item or serv-
ice were submitted to such plan dur-
ing such period. 
‘‘(iii) MANNER OF SUBMISSION.—Rate 
and payment information required to be 
submitted and made available under this 
subparagraph shall be so submitted and so 
made available in 3 separate machine-read-
able files corresponding to the information 
described in each of subclauses (I) through 
(III) of clause (ii) that meet such require-
ments as specified by the Secretary 
through rulemaking. Such requirements 
shall ensure that such files are limited to 
an appropriate size, are made available in 
a widely-available format that allows for 
information contained in such files to be 
compared across health plans, and are ac-
cessible to individuals at no cost and with-
out the need to establish a user account or 
provider other credentials. 
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‘‘(iv) USER GUIDE.—Each health plan 
shall make available to the public instruc-
tions written in plain language explaining 
how individuals may search for information 
described in clause (ii) in files submitted in 
accordance with clause (iii). 
‘‘(F) DEFINITIONS.—In this paragraph: 
‘‘(i) PARTICIPATING PROVIDER.—The 
term ‘participating provider’ has the mean-
ing given such term in section 2799A–1 of 
the Public Health Service Act. 
‘‘(ii) IN-NETWORK
RATE.—The term 
‘in-network rate’ means, with respect to a 
health plan and an item or service fur-
nished by a provider that is a participating 
provider with respect to such plan and 
item or service, the contracted rate in ef-
fect between such plan and such provider 
for such item or service.’’. 
(c) REPORTS.— 
(1) COMPLIANCE.—Not later than January 1, 
2025, the Comptroller General of the United States 
shall submit to Congress a report containing— 
(A) an analysis of health plan compliance 
with the amendments made by this section; 
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(B) an analysis of enforcement of such 
amendments by the Secretaries of Health and 
Human Services, Labor, and the Treasury; 
(C) recommendations relating to improving 
such enforcement; and 
(D) recommendations relating to improving 
public disclosure, and public awareness, of in-
formation required to be made available by such 
plans pursuant to such amendments. 
(2) PRICES.—Not later than January 1, 2028, 
the Comptroller General of the United States shall 
submit to Congress a report containing an assess-
ment of differences in negotiated prices (and any 
trends in such prices) in the private market be-
tween— 
(A) rural and urban areas; 
(B) the individual, small group, and large 
group markets; 
(C) 
consolidated 
and 
nonconsolidated 
health care provider areas (as specified by the 
Secretary); 
(D) nonprofit and for-profit hospitals; 
(E) nonprofit and for-profit insurers; and 
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(F) insurers serving local or regional areas 
and insurers serving multistate or national 
areas. 
(d) EFFECTIVE DATE.— 
(1) IN GENERAL.—The amendments made by 
subsection (a) shall apply beginning January 1, 
2025. 
(2) CONTINUED APPLICABILITY OF RULES FOR 
PREVIOUS
YEARS.—Nothing in the amendments 
made by this section may be construed as affecting 
the applicability of the rule entitled ‘‘Transparency 
in Coverage’’ published by the Department of the 
Treasury, the Department of Labor, and the De-
partment of Health and Human Services on Novem-
ber 12, 2020 (85 Fed. Reg. 72158), before January 
1, 2025. 
Æ 
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