Getting Clarity on Transparency: What Health Plan Sponsors Need to Know about Publishing Machine-Readable Files - Bim Group

Getting Clarity on Transparency: What Health Plan Sponsors Need to Know about Publishing Machine-Readable Files

READ TIME: 10 MINUTES

As of July 1, 2022, group health plans must clear one of the first major compliance hurdles required by the Affordable Care Act’s (ACA) Transparency in Coverage (TiC) Final Rules. By that date, plans and insurance carriers must have prepared and posted two machine-readable files (MRFs) to a public website so individuals can readily learn their in-network group health plan costs as well as historical paid amounts for out-of-network services. (A third MRF relating to prescription drugs will be required later and is not subject to the July 1, 2022, deadline.) There is still some confusion surrounding the MRF requirement, so this Advisor is designed to provide important context and actionable steps for plan sponsors to understand their transparency obligations as they cope with the new TiC disclosure requirement.

 

Download the Advisor for a deep dive into the requirements for machine-readable files and the obligations for plan sponsors.

This information has been prepared for UBA by Fisher & Phillips LLP. It is general information and provided for educational purposes only. It is not intended to provide legal advice. You should not act on this information without consulting legal counsel or other knowledgeable advisors.

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