Effective July 1, 2022 CMS will enforce the Transparency in Coverage rules on most group health plans. For plans and issuers that are subject to CMS’s enforcement authority, they are required to comply with Machine-Readable Files for in-network rates and allowed amounts for, and billed charges from, out-of-network providers. 

SIMNSA is working in good faith to implement requirements of the Machine-Readable Files (MRF) provision for July 1, 2022.

These links are available below.

Self-funded plan sponsors may post this link on their own websites for compliance purposes. It is up to the self-funded plan to determine where on its site to publish this link, but the link must be publicly available (no login or other requirements should be required to access the MRF files).