Elevance Health Announces New Policies To Improve Billing Transparency and Help Lower Health Care Costs

INDIANAPOLIS — September 29, 2026 — Elevance Health today announced plans to implement a series of new billing policies designed to make it clearer where patients receive care and help ensure health care services are paid at the appropriate rate.

The policies will apply across Elevance Health’s commercial, Medicare Advantage and Medicaid businesses. They are intended to address increasingly common situations where care provided at an off-campus location is billed at a higher hospital rate.

The new policies will:

• Require hospitals to identify the physical location where care was provided.
• Check billing information against hospital addresses to confirm where care took place.
• Pay certain off-campus hospital services at the appropriate off-campus rate.
• Prevent higher hospital billing for certain lab tests performed somewhere else.

Elevance Health plans to implement individual policies throughout 2026 and 2027. Earlier this year the company notified providers that certain services taking place at off-campus hospital locations will be reimbursed at the applicable off-campus rate. It is the first commercial market payer to announce their intent to require hospitals to include physical location on billing forms and adjust rates for off-campus care accordingly. One member who experienced this inaccurate billing practice saw their medical bill increase by more than ten times the normal amount.

“Patients and employers should be able to trust that health care bills accurately reflect where care was provided,” said Catherine Gaffigan, M.D., President of Health Solutions at Elevance Health. “These changes will give us better information to help us pay accurately and support our work to make health care more affordable.”

The policies are being rolled out during 2026 and 2027 and are consistent with a growing federal and state focus on how outpatient care is billed and paid.

"ERIC spent years advocating for honest billing requirements for providers, and Congress enacted reforms earlier this year to ensure employer-sponsored health plans and insurers will now know exactly where care takes place,” said James Gelfand, President and CEO of The ERISA Industry Committee (ERIC). “We are pleased to see leading carriers like Elevance Health harnessing that information to drive value for employers and patients.”

States including Indiana and Maine have strengthened billing requirements to ensure accurate payments for off-campus care, and the federal government is requiring greater transparency for certain off-campus hospital services. New federal requirements for off-campus hospitals are scheduled to take effect in 2028.

The cost impact can be significant. The Blue Cross Blue Shield Association estimated that Medicare paid an additional $2.7 billion and patients paid $411 million more out of pocket over three years when certain services were delivered in hospital outpatient settings rather than physician offices, where those services could have been appropriately provided. The findings underscore the need for greater site-of-care transparency and more appropriate payment.

“When the same service costs more because a hospital owns a doctor's office or clinic, workers and families are saddled with higher premiums and cost sharing,” Gelfand said. “This kind of innovation should become the norm, and Congress should take further steps to enforce transparency in billing and site-neutral payments."

The policy changes come as hospital spending continues to rise. According to federal data, U.S. spending on hospital care increased 10.6% in 2023 and another 8.9% in 2024, reaching about $1.6 trillion. Hospital care accounted for 31% of all U.S. health care spending in 2024, underscoring the importance of efforts to make care more affordable. (Centers for Medicare & Medicaid Services)

“Increasingly, our customers demand affordability, and we have a responsibility to deliver that to them,” Gaffigan said. “These actions will help us address wasteful spending and manage premiums, while helping our members get the right care, in the right place, at the right time.”

Gaffigan announced the new policies during an appearance at the MAHA Summit today in Washington, DC.

About Elevance Health

Elevance Health is a lifetime, trusted health partner whose purpose is to improve the health of humanity. The company supports consumers, families, and communities across the entire healthcare journey – connecting them to the care, support, and resources they need to lead better lives. Elevance Health’s companies serve approximately 104 million consumers through a diverse portfolio of industry-leading medical, pharmacy, behavioral, clinical, home health, and complex care solutions. For more information, please visit www.elevancehealth.com or follow us @ElevanceHealth on X and Elevance Health on LinkedIn.

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