Transparency in Coverage: Machine-Readable Files
Effective July 1, 2022, the Transparency in Coverage (TIC) regulations require health insurers and group health plans to disclose cost-sharing information to participants and make pricing information for medical items and services publicly available through machine readable files (MRFs), which contain the negotiated rates for in-network providers and allowed amounts derived from historical claims for out-of-network providers. These files follow the Centers for Medicare & Medicaid Services-approved JSON format and are not meant for a consumer-friendly search of rates, benefits or cost sharing.