Machine Readable Files & Cost Transparency
As part of the No Surprises Act and Transparency in Coverage Final Rule set forth by the U.S. Department of the Treasury, the U.S. Department of Labor, and the U.S. Department of Health and Human Services, group health plans and health insurance issuers are required to make available to the public negotiated rates for all covered items with in-network providers, and historical payments to and billed charges from, out-of-network providers through machine-readable files (MRFs) posted on an internet website, updated monthly. These files will permit the public to have access to health plan payment information that can be used to understand health plan pricing and the cost for health care services.
All files must conform to a non-proprietary, open standard format, like JSON, XML or YAML, and be made available via HTTPS. The content of the files is formatted to technical standards in guidance published by the Centers for Medicare & Medicaid Services (CMS).
Access to Machine Readable Files
Links will be posted on 7/1/2022.