On November 12, 2020, the Federal government issued 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:
1. Network negotiated rates for all items and services.
2. Historical payments to, and billed charges from, out-of-network providers.
Machine Readable Files contain information required by federal regulations and apply to certain types of health plans or issuers. These files, often called “MRFs,” are updated monthly and formatted in accordance with federal standards. MRFs are intended to promote transparency, and are one of several different types and places to obtain information on costs.
IN-NETWORK MACHINE READABLE FILE:
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