Transparency in Coverage Rule

What is the "Transparency in Coverage Rule"?

The Transparency in Coverage Rule issued by the federal government requires health insurers and group health plans to provide detailed pricing data for all covered items and services to the public in the form of Machine Readable Files (MRFs). Information such as In-Network Rates for all covered in-network items and services, Out-of-Network historical rates for all covered items, services and prescription drugs, and In-Network negotiated rates and historical net prices for all covered prescription drugs by plan at the pharmacy location level. The link to the right leads to the machine readable files that are made available in response to the federal Transparency in Coverage Rule and includes negotiated service rates and out-of-network allowed amounts between health plans and healthcare providers. The machine-readable files are formatted to allow researchers, regulators, and application developers to more easily access and analyze data.