The Transparency in Coverage Rule, issued in 2020 by the U.S. Department of Health & Human Services, U.S. Department of Labor, and U.S. Department of the Treasury, requires insurers and group health plans to publish machine-readable files starting July 1, 2022. These files contain in-network rates and out-of-network allowed amounts. Under the Transparency in Coverage Final Rule, plans and issuers will disclose pricing information to the public through machine readable files accessible via a table of contents file. One file requires disclosure of negotiated rates between plans and providers for covered items and services, known as the In-Network File. The second file discloses unique allowed amounts and billed charges for out-of-network services, known as the Out-of-Network Allowed Amount File.
The machine-readable files for UNM Medical Plans can be accessed from the links below:
