CHECK Act of 2026

The CHECK Act of 2026 requires healthcare intermediaries, such as pharmacy benefit managers and third-party administrators, to provide group health plans with quarterly, detailed reports on their pricing formulas, rebates, and fees without charge. This legislation also mandates that these providers supply specific data on alternative payment models and prohibits contract clauses that delay or restrict access to this financial information. Additionally, the bill expands transparency for patients by requiring health plans to send itemized explanations of benefits within 45 days of a payment request and obligating healthcare providers to issue itemized bills that include plain language descriptions, billing codes, and charity care information. These new reporting and billing requirements are designed to help plans verify costs and enable patients to better understand their medical expenses. Non-compliance with these disclosure rules could result in civil penalties of up to $100,000 per day for service providers and up to $10,000 per instance for healthcare facilities.