BCBS of ALABAMA: TRANSPARENCY IN COVERAGE FINAL RULE (85 FR 72158-01)
On 11/12/2020, the Department of Health and Human Services (HHS), the Department of Labor, and the Department of the Treasury published the Transparency in Coverage Final Rule (85 FR 72158-01). The Transparency in Coverage Rule requires that group health plans and health insurance issuers provide in-network provider negotiated rates and historical out-of-network allowed amounts as machine-readable files to members and to the public in order to help members make informed decisions about their healthcare.
Enforceable beginning 7/1/2022, the first phase of the Transparency in Coverage Rule requires group health plans and health issuers to:
- Publicly disclose negotiated rates for in-network providers and allowed amounts for out-of-network providers
- Provide the information in machine-readable files that will be available beginning on or after 7/1/2022