Access Imperative Coverage Information for New Government Requirements
On July 1, 2022, the file requirements of the federal government’s Transparency in Coverage Rule took 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.
Since July 1, 2022, Macomb County is able to 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, and we do not recommend or prescribe a particular application. We 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.
Our Healthcare Cost Estimator Tool for members can be accessed by logging into our member portal. This tool is enhanced to meet the January 1, 2023, Transparency in Coverage requirements for the 500 shoppable services required under the rule.