Effective July 1, 2022, SISCO will be posting Machine-Readable Files (MRF) in compliance with the Transparency in Coverage rule.
A QUICK RECAP
The Federal Government issued the Transparency in Coverage (TiC) Final Rule on November 12, 2020, and subsequently the Consolidated Appropriations Act (CAA) 2021 included additional provisions regarding TiC. Under TiC, group health plans must provide machine-readable files (MRFs) that contain pricing information, including:
It is important to note that the point of the release of these cost data files has nothing to do with employee or plan participant communication, but rather, this rule requires insurance companies and self-insured plans to publicize what they pay providers for medical services and make that available to the public. One of the primary goals of this requirement is that the information can then be gathered broadly, and data analytics run to provide more transparency across the industry.
MACHINE-READABLE FILES
A machine-readable file is a digital representation of data or information that can be imported by a computer system without any intervention. These files must be in a Center for Medicare & Medicaid Services approved format and are not consumer-friendly or intended for consumer use. You can read more about the Requirement to Post Machine-Readable Files here.
YOUR OBLIGATIONS AS AN EMPLOYER GROUP
To ensure compliance with the TiC MRF Requirements, Employer Groups should post a link to the SISCO publicly accessible site on their public website and not their private intranet.
If you have questions, please reach out to your SISCO Client Relations Manager.