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The Price Transparency Enforcement Gap: Hospitals Got the Warning. Health Plans and TPAs Are Next. This month, the Associated Press reported that federal regulators warned more than 500 hospitals to fix their price transparency data or face fines of up to $2 million a year. The list the AP obtained covers 519 enforcement actions reaching…

The No Surprises Act arbitration system is producing results Congress never intended — and the fix isn’t more rules. It’s better data.   A plastic surgeon in New York just won $440,000 in a single arbitration case for a breast reduction his own website advertises at $15,000 to $25,000. He’s won more than 85% of…

The proposed CMS-9882-P rule seeks to address structural limitations in current Transparency in Coverage (TiC) machine-readable files (MRFs) by improving usability, reducing file sizes, and introducing greater standardization. TALON strongly supports the Departments’ effort to reform the structural failures of the current transparency framework. While the proposal represents meaningful progress, additional requirements around context, accountability,…

For more than a decade, the movement toward consumer-directed healthcare has empowered individuals to take a more active role in how they spend their healthcare dollars. High-deductible health plans (HDHPs), the Transparency in Coverage Rule, and the Consolidated Appropriations Act of 2021 laid important groundwork, improving consumer awareness, reshaping benefit design, and driving a fundamental…

When employers and employees share transparent information, fair incentives, and a smooth way to earn rewards, everyone makes smarter choices — TALON’s MyMedicalRewards and TALONPay make that alignment real. Why Alignment Matters Now For millions of American employees, healthcare decisions have become one of the most confusing and financially stressful parts of life. Even the…

Ethical Price Transparency for the Commercial Insurance Era Commercial health insurance is the arena where price transparency reform will be won or lost. More than 180 million Americans rely on employer-sponsored or individual commercial coverage, yet these markets remain opaque, fragmented, and deeply misaligned with consumer and employer interests. A recent U.S. Senate hearing —…

The Fiduciary Blind Spot Employer group fiduciaries have never faced greater pressure or greater scrutiny concerning their healthcare budget. The Consolidated Appropriations Act (CAA) of 2021 and the Transparency in Coverage (TiC) Rule fundamentally shifted responsibility for healthcare cost oversight onto plan sponsors. No longer can CFOs, controllers, or benefits committees rely solely on reports…

For Health Plan and TPA leaders, the regulatory era of transparency has set the stage for a competitive battleground. Compliance alone was never a differentiation strategy. To truly compete in the market and gain a competitive edge, price transparency data must be expertly curated, integrated, and delivered. TALON’s platform transforms raw machine-readable file (MRF) data…

Reference-Based Pricing (RBP) has long been positioned as a solution to rising healthcare costs by anchoring reimbursements to a benchmark of Medicare. While it can generate near-term savings, RBP is plagued by volatility, provider abrasion, member balance billing, and administrative overhead. TALON’s Universally Acceptable Payment Amount (UAPA) offers a more sustainable alternative. UAPA is a…

“A hero is someone who has given his or her life to something bigger than oneself.” – Joseph Campbell   The Wall Street Journal just rang the bell: employer health insurance costs are projected to jump nearly 10% in 2026 — the steepest rise in 15 years. This is the call to adventure for every…