The Transparency in Coverage Final Rules (TiC Final Rules) require group health plans and health insurance issuers to disclose on a public website detailed pricing information in three separate machine-readable files (MRFs). Specifically, the following information must be disclosed:
- First file: In-network provider negotiated rates for covered items and services (the “In-network Rate File”);
- Second file: Historical payments to and billed charges from outof-network providers (the “Allowed Amount File”); and
- Third file: In-network negotiated rates and historical net prices for covered prescription drugs (the “Prescription Drug File”)—this particular MRF requirement is delayed until further notice.
The files must be publicly available and accessible free of charge without any restrictions.
