IMPORTANT INFORMATION below regarding your obligation to provide a Machine-Readable File by July 1, 2022. Please read and respond accordingly.
To meet the requirements of the Transparency in Coverage (TiC) Rules that will be enforced starting on July 1, 2022, plan sponsors must create two files — one to disclose in-network provider rates for covered items and services and another to disclose out-of-network allowed amounts and billed charges for covered items and services. Both files must be machine-readable, meaning they must conform to an open standard format such as XML or JSON and be made available from a searchable, secure link on the internet.
Diversified Group, in partnership with TALON, has been working on developing machine-readable files that meet the rules requirements to ensure that your plan is compliant by the deadline. However, once this file is created, the files must be posted on an internet website that is publicly available and accessible to any person free of charge. No conditions can be imposed on the access to the files, such as establishment of a user account, password, or other credentials or submission of personally identifiable information to access the file.
The TiC Rules provide that the machine-readable files may be “hosted on a third-party website” and plan administrators and carriers may contract with third parties to post the file; however, “if a plan sponsor chooses not to host the file separately on its own website, it must provide a link on its own public website to the location where the file is made publicly available.”
Because these files will be large and require monthly updating, we have arranged to host the file on your behalf on an outside platform. However, per the rules, you will be required to provide a link to the files on your public website. For those with a public website, you will receive future instructions on how to link to the files once development is complete.
If you do not have a public website, please notify our compliance team (contact information below) as soon as possible so we may be able to determine a compliant means of access for the file.
Dave Follansbee, VP of Operations and Compliance
email@example.com or (860) 295-6531
Laura Williams, Business Development and Compliance Consultant
firstname.lastname@example.org or (860) 612-8644