Let's be

Rx Savings Solutions has been offering price transparency in the prescription drug market for more than a decade. It’s what we do. 

Are you ready to address federal regulations aimed at giving consumers access to real-time healthcare costs—including drug pricing?

Our proven solution can help make sure you are.

rxss transparency explainer image

The basics: New CMS Requirements

The Centers for Medicare and Medicaid Services (CMS) Transparency in Coverage (TiC) rule requires private insurers to post real-time cost-sharing information, out-of-pocket coverage rates and in-network drug pricing. In short, transparency is no longer voluntary. Penalties for non-compliance could be as high as $300 per plan participant per day.

NEW UPDATE: While enforcement of these new regulations may be delayed, here are some key dates to keep in mind:

Timeline showing July 2021, January 2023 and January 2024

Historical drug prices, in-network rates, out-of-network historic payments and billed charges must be made public.

Standard costs for an initial list of 500 medical items and services must be available in an internet-based self-service tool.

Costs for all covered services and prescription drugs must be available in an internet-based self-service tool.

July 2022

Historical drug prices, in-network rates, out-of-network historic payments and billed charges must be made public.

january 2023 icon

Standard costs for an initial list of 500 medical items and services must be available in an internet-based self-service tool.

january 2024 icon

Costs for all covered services and prescription drugs must be available in an internet-based self-service tool.

An older man and woman drinking tea and laughing

What About
Medicare Advantage?

Effective January 2023, another CMS regulation (CMS-4190-F2) will require Part D plans to offer their beneficiaries access to a Real-Time Benefit Tool (RTBT). This comparison tool must allow enrollees to review options under their current prescription drug plan and give them the ability to choose lower-cost alternative therapies. Fortunately, our solution already meets these RTBT requirements.

ready for transparency rules?

EHIR members were polled to learn how they’re planning for Transparency in Coverage (TiC)(TiC) Rx requirements as the July 2022 deadline approaches. See the full research and white paper created by EHIR and RxSS to learn more about what EHIR members are doing to prepare for TiC requirements.
EHIR logo

Transparency Blog Series

Check out our ongoing blog series on price transparency to learn more about what these new regulations will mean to your organization.

A customer paying at the pharmacy using a prescription discount card

How Payers Can Leverage the Cash Pharmacy and Discount Card Trend

Consumers have more choices for purchasing prescriptions without insurance. How can plans capture what they’re missing?

Read More
Pharmacist in a pharmacy taking inventory of medications in stock

The Adderall Shortage Is Real – Here’s How RxSS Helps Members

We know many members are scrambling to find pharmacies with the common ADHD medication in stock. With this and other drug shortages, RxSS can be an invaluable resource.

Read More
A syringe containing an expensive biologic drug like Humira

Humira Biosimilars and other Biologic Alternatives

A wave of FDA-approved biosimilars for Humira and other costly biologics will enter the U.S. market in 2023. What does it mean for patients, payers and plan designs?

Read More
Two doctors and two pharmacists consulting one another in a clinical setting

Prescription Drug Options – Pharmacist Curated, Doctor Approved

Members shouldn’t confuse our clinical suggestions for intervention. Medication decisions are between patient and doctor. RxSS informs those discussions, and makes it easy to make a change.

Read More

Why Transparency Matters

Aside from avoiding costly penalties, you may be asking: Why should I embrace price transparency? The answer really comes down to trust. By educating your members on all their medication options, you solidify your role as trusted partner. And with trust comes three key benefits:

Looking Beyond Compliance

After more than 10 years helping our clients and members make sense of prescription drug pricing, we’ve learned that simply complying with regulations isn’t enough. Yes, RxSS technology creates the drug price transparency CMS is soon requiring. But we take that data a step further and share it with members in a way that empowers them to take action and take control of their out-of-pocket drug costs. Here’s how we do it:

Offer a proven platform for member engagement. How it Works

Partner with health plans and employers to drive ROI.

Client Case Study

Enhance the experience for Medicare Advantage members. More About MA
Someone viewing their Rx Savings Solutions member account on a latptop

Request a demo

We can talk about it and get deep into the weeds, but seeing is believing.

What you Can Expect

green checkmark icon

A clear picture of clinical strength, plan integration and a simple, intuitive user experience.

green checkmark icon

How easy it is for a member to save money for themselves and your plan.

green checkmark icon

Why Rx Savings Solutions blows away other so-called "savings tools."