Transparency

Kaiser Permanente and Prescription Drug Data Collection Reporting (RxDC) Requirements

As part of the Consolidated Appropriations Act, Kaiser Permanente is required to submit information about prescription drug and health care spending on behalf of all fully insured and self-funded grou...

Aetna and Prescription Drug Data Collection Reporting (RxDC) Requirements

As part of the Consolidated Appropriations Act, 2021 (CAA), which was signed into law on December 27, 2020, health insurance issuers and group health plans are required to submit information about pre...

Sharp Health Plan and Prescription Drug Data Collection Reporting (RxDC) Requirements

The Transparency in Coverage rule requires health plans to share health care costs for members to make informed decisions on how they receive care. There are two main phases of the rule. The first ...

UnitedHealthcare and Prescription Drug Data Collection Reporting (RxDC) Requirements

Under the Consolidated Appropriations Act (CAA), health insurers offering group or individual health coverage and self-funded (ASO) group health plans are required to report data annually regarding pr...

Anthem and Prescription Drug Data Collection Reporting (RxDC) Requirements

Anthem sent an email to employers in September outlining Prescription Drug Data Collection (RxDC) reporting requirements that begin December 27, 2022. The RxDC reporting provision of the Consolidat...

Has the Prescription Drug Reporting Requirement Been Delayed?

Question: I’ve heard that the prescription drug reporting requirement under the transparency rules was delayed. Does this mean I don’t need to worry about any impending requirements? Answer: T...

Health Cost Transparency Guide for Employers

The Consolidated Appropriations Act (CAA), No Surprises Act (NSA), and the Transparency in Coverage Final Rule (TiC Final Rule) impose several new requirements on employer-sponsored group health plans...

MediExcel Transparency in Coverage: Machine-Readable Files

Beginning July 1st, 2022, the Transparency in Coverage Rules (TIC Rules) requires group health plans and health insurance issuers to make available to the public, negotiated rates for all covered item...

Blue Shield of California Transparency in Coverage: Machine-Readable Files

Blue Shield of California is working in good faith to implement requirements of the Machine-Readable Files (MRF) provision of the Transparency in Coverage Final Rule (TCFR) for July 1, 2022. These ...

Aetna Transparency in Coverage: Machine-Readable Files

The Transparency in Coverage rule requires health plans and insurers to disclose pricing information via MRF by July 1, 2022. Health plans must generate two MRFs that contain: Negotiated rates f...

Anthem Transparency in Coverage: Machine-Readable Files

Transparency in Coverage (TIC) regulations require health insurers and group health plans to create machine readable files (MRFs) that contain the negotiated rates for in-network providers and allowed...

The Transparency in Coverage Rule for Machine-Readable Files Deadline is Approaching

The deadline for Transparency in Coverage Machine-Readable Files is July 1, 2022 The Transparency in Coverage (TiC) rule is part of the federal transparency efforts that require insurers and group ...