Transparency in Coverage Compliance: Machine-Readable Files will be available July 1
June 28, 2022
The following is a gentle reminder with information regarding the Transparency in Coverage (TiC) Final Rule. Under this Rule, group health plans must create and publish machine-readable files (MRFs) that contain detailed pricing information, including:
- Network negotiated rates for all items and services.
- Historical payments to, and billed from charges from, out-of-network providers.
Group health plans are required to make these files available to the public from an open-access internet website effective July 1, 2022.
How Allied will support its clients
- By July 1st, Allied will create and publish the MRFs for the medical plans that Allied administers (at this time the pharmacy MRF are delayed pending additional rulemaking).
- Allied will host the files on each client’s behalf to a publicly accessible MRF Hub website at alliedbenefit.sapphiremrfhub.com and will update the files on the first of each month.
- Allied has also posted the MRF Hub website link to its public website here.
- Note, that the MRF Hub website link will not be active until July 1, 2022.
What Employers need to do
To ensure the Group Health Plan is in compliance with the TiC MRF Rule requirement, Employers should be prepared to post the MRF Hub website link(alliedbenefit.sapphiremrfhub.com) on their own company’s public-facing website.
If you have any questions, please do not hesitate to get in touch with your Allied Account Manager.
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These materials have been prepared by Allied Benefit Systems, LLC for general informational purposes only. These materials do not constitute legal or tax advice. Receipt of this information does not create an attorney-client relationship, and readers should not act upon information in this publication without professional counsel. No reproduction or redistribution is allowed without written permission of Allied Benefit Systems, LLC.