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Machine-Readable Files to Be Posted by July 1, 2022

machine readable files

1.5 minute read

The Transparency in Coverage Final Rules require health insurance issuers and plans to disclose detailed pricing information on a public website. The three machine-readable files (MRFs) that must be posted include:

  1. In-Network Rate File: In-network provider negotiated rates for covered services and items.
  2. Allowed Amount File: Historical payments to and billed charges from out-of-network providers.
  3. Prescription Drug File: In-network negotiated rates and historical net prices for covered prescription drugs. This MRF requirement is delayed until further notice.

The MRF requirements were supposed to go into effect for plan years beginning on or after January 1, 2022, but now the first two requirements will be enforced starting July 1, 2022.

For 2022 plan years beginning after July 1, 2022, MRFs must be posted in the month in which the plan year begins (for example, September 1, 2022, for a plan year that is from September 1st to August 31st).

Employers should confirm that written agreements addressing MRFs are in place with their carriers and TPAs and that these files will be available by the applicable deadline.

Download the bulletin for more details.

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National Insurance Services is not a law firm and no opinion, suggestion, or recommendation of the firm or its employees shall constitute legal advice. Readers are advised to consult with their own attorney for a determination of their legal rights, responsibilities and liabilities, including the interpretation of any statute or regulation, or its application to the readers’ business activities.

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Mari Wagner

Mari Wagner

The greatest badge of success for Mari Wagner is when her customers reach out and let her know how appreciative they are of her help and services. Mari is dependable, driven, committed, and enjoys meeting new people. Mari joined the National Insurance Services (NIS) team after working with NIS for several years on mutual clients benefit plans. She finds that NIS has similar values and mindset to her own. As an Account Manager, Mari works with schools, cities, and counties in the Midwest Region. She is a licensed insurance agent with a background in sales, wellness, managing insurance pools, marketing, and consulting.