Health Care Transparency in Cost and Quality Information


Effective Dec. 27, 2020, the Consolidated Appropriations Act, 2021 includes provisions designed to expand transparency in cost and quality information for health care consumers and employer groups.

As a result, our provider network contracts no longer restrict EmblemHealth from:


(i) Disclosing provider-specific cost or quality-of-care information or data, through a consumer engagement tool or any other means, to referring providers, employer groups, members, or individuals eligible to become members; and

(ii) Electronically accessing and sharing, in accordance with applicable privacy regulations, de-identified claims and encounter information or data with a business associate for plan administration and quality improvement purposes.


Be sure to share this regulatory update with your business leadership and/or privacy team, as appropriate.