HHS Announces Real-Time Prescription Drug Price Transparency Starting October 1

The U.S. Department of Health and Human Services announced a regulatory breakthrough that will provide doctors and patients with real-time access to prescription drug information, enabling them to identify the most appropriate and cost-effective treatments while preventing health insurers from blocking physician-approved care. The final rule, taking effect October 1, will allow millions of Americans to compare drug prices, view out-of-pocket costs, and access prior authorization requirements for the first time.

The regulation, finalized through the HHS Assistant Secretary for Technology Policy/Office of the National Coordinator for Health Information Technology (ASTP/ONC), ensures healthcare providers using certified health IT systems can submit prior authorizations electronically, select drugs consistent with patient insurance coverage, and exchange electronic prescription information with pharmacies and insurance plans. This reform builds upon existing Centers for Medicare & Medicaid Services (CMS) policies and expands interoperability across the healthcare ecosystem to reduce administrative burdens for patients, providers, and payers.

The announcement follows a June 2025 roundtable meeting between Secretary of Health and Human Services Robert F. Kennedy, Jr., CMS Administrator Dr. Mehmet Oz, Director of Medicare Chris Klomp, and major health insurers covering nearly eight in ten Americans. During this meeting, health insurers committed to six key reforms aimed at cutting red tape, accelerating care decisions, and enhancing transparency for patients and providers across Medicare Advantage, Medicaid Managed Care, Medicare Part D, Health Insurance Marketplace, and commercial plans.

"I commend CMS and ASTP/ONC for moving decisively to overhaul our nation's broken prior authorization system," said Secretary Kennedy. "By improving patient outcomes, cutting provider burden, and ensuring full transparency at the point of care, we are delivering on our promise to Make America Healthy Again."

CMS Administrator Dr. Mehmet Oz emphasized the importance of removing barriers to timely treatment, stating, "This is another step toward delivering on a promise to patients and providers: less red tape, faster answers, and more time focused on care. Prior authorization should never stand in the way of timely treatment, and by working with ASTP/ONC and health insurers, CMS is building a system where decisions are transparent, predictable, and centered on patient needs. This is about making care simpler, fairer, and more affordable."

The complementary policies from CMS and ASTP/ONC will accelerate electronic prior authorization processes, building on existing CMS requirements for certain payers. Healthcare providers will submit prior authorizations electronically using ASTP/ONC certified health IT, resulting in faster care authorization decisions and increased transparency. The improvements in workflow automation and more timely decision-making have the potential to save millions of hours of clinician time and billions of dollars in labor costs, allowing clinicians to spend more time with patients rather than on paperwork.

Click here for the original news story.