Transparency in Coverage Rule Pertaining to Payer Transparency Machine-readable Files (MRF)
On July 1, 2022, the machine-readable file requirements of the federal government’s Transparency in Coverage Rule will take effect. This rule requires health insurers and group health plans to make publicly available machine-readable files for:
- Negotiated rates for all covered items and services between the plan and in-network providers.
- Historical payments to, and billed charges from, out-of-network providers for covered items and services.
- The pharmacy file requirement has been delayed pending additional guidance.
Beginning July 1, 2022, Benesys can access our machine-readable files from this page, by clicking the button below:
The data file in a JSON format. There are many open and free applications available to open a JSON file. HAP is not defining or prescribing any particular one and would recommend working with your IT organization as appropriate.
Do you have a question about what the Transparency in Coverage Rule means to you? Click the button below.