On November 12, 2020, the Departments of Health and Human Services, Labor and the Treasury finalized the Transparency in Coverage Rule that requires health insurers and group health plans to create a member-facing price comparison tool and post publicly available machine-readable files that include in-network negotiated payment rates and historical out-of-network charges for covered items and services, including prescriptions drugs. Data in machine readable files (MRF) must be updated monthly.
More details regarding the Transparency in Coverage Rule can be found here:
ACCESS TO INFORMATION
In an effort to make this information readily available, BCG will continually update this page with up to date information and content. Below are links to our current carrier partners and their information specific to TRANSPARENCY IN COVERAGE.
Each carrier specific link below leads to the machine readable files that are made available in response to the federal Transparency in Coverage Rule and includes negotiated service rates and out-of-network allowed amounts between health plans and healthcare providers. The machine-readable files are formatted to allow researchers, regulators, and application developers to more easily access and analyze data.