Transparency

meaningful transparency efforts that help consumers make informed health care decisions. In August 2021, the Department of Labor, in conjunction with the Departments of Health and Human Services (HHS) and the Treasury (known collectively as the “Tri-Agencies”) issued updated guidance related to implementation of the Consolidated Appropriations Act (CAA) and Transparency in Coverage (TIC) final rule. One provision of the rule requires Health Plans to make machine-readable files (MRF) publicly available beginning on July 1, 2022 (delayed from Jan. 1, 2022). The MRFs must contain negotiated rates with in-network providers for all covered items and services as well as historical payments to, and billed charges from, out-of-network providers. The requirement to post an MRF containing the in-network negotiated rates and historical net prices for all covered prescription drugs by plan or issuer at the pharmacy location level has been deferred until further notice and comment rulemaking. The purpose of the rule is to provide transparency federal regulators, researchers, and application developers easier access to data for analyzing. The federal government also believes having this data published will promote consumer choice as well as competition among providers.