Health-Care Oversight Rule Changes Create Legal Risk for US Employers
Regulations aimed at boosting transparency allow greater control over spending, but companies could face lawsuits if they fail to use that information.
US employers spend more than $1 trillion a year on health insurance for workers and their families. While they’ve long had a fiduciary duty to ensure that those funds are spent prudently, most have relied on insurers and other middlemen to define benefits, negotiate prices with physicians and hospitals, and pay claims. Now new federal policies are adding pressure to companies to make sure they’re not squandering employees’ health benefit money.
That won’t be easy in a health-care system where a quarter of spending is wasted and the cost and quality of care vary wildly. The details of prices and fees have long been hidden from employers, kept secret in private contracts worked out by insurers, hospitals and benefits consultants. New measures aim to force them into the open, making it easier for companies to understand where their money is going.