The Departments of the Treasury, Labor, and Health and Human Services (the Departments) have issued the Transparency in Coverage final rules (85 FR 72158) on November 12, 2020. The final rules require non-grandfathered group health plans and health insurance issuers in the individual and group markets (plans and issuers) to disclose certain pricing information. Under the final rules a plan or issuer must disclose in-network negotiated rates and billed and out-of-network allowed through machine-readable files.
Plans and issuers are required to make these files public starting in 2022.
This material is for information only. Health information programs provide general health information and are not a substitute for diagnosis or treatment by a physician or other health care professional.
SFPI is committed to providing links to Machine Readable Files (MRF) from PPO networks as they become available.