Transparency in Coverage Final Rule (CMS-9915-F)

The Departments of the Treasury, Labor, and Health and Human Services (the Departments) have issued the Transparency in Coverage final rules (85 FR 72158) on November 12, 2020. Below are the required machine-readable files associated with Transparency in Coverage:

In-Network Files

  1. 2022-07-21_FEDERAL-EMPLOYEE-HEALTH-BENEFITS—IA-FULLY-INSURED
  2. 2022-07-21_FIRST-CAROLINA-CARE-FULLY-INSURED
  3. 2022-07-21_HEALTH-ALLIANCE-COMMERCIAL-SIMPLETE-FULLY-INSURED
  4. 2022-07-21_HEALTH-ALLIANCE-MEDICAL-PLANS-FULLY-INSURED
  5. 2022-07-21_HEALTH-ALLIANCE-NORTHWEST-FULLY-INSURED
  6. 2022-07-21_HEALTH-ALLIANCE-SELF-FUNDED-BALANCE

Out-of-Network Allowed Amount Files

Additional Transparency in Coverage Files

In accordance with the rule, the machine-readable files are available for download and consistent with required format found on github and published by CMS. These files are updated monthly starting July 1st, 2022.

Transparency in Coverage Rule Frequently Asked Questions