Transparency in Coverage
The Fund is required to post certain information on a public website pursuant to the Federal Transparency in Coverage Final Rule published in the Federal Register on November 12, 2020.
The Transparency Rule is intended to make information about the prices charged for health care available to the general public, particularly researchers. These experts can use pricing information from the Fund and other health plans to better understand the health care system and its costs and, hopefully, create new policies that improve competition and lower health care spending.
The Transparency Rule requires that the Fund post links to machine-readable files that contain information about the price of health care services. A machine-readable file is written in computer code and is an extremely large file. It is not intended to be downloaded or read by participants but to be used in research studies. The files do not contain Protected Health Information about you or your family. Below is a link to the required machine-readable files.
Links on this website provide machine-readable files for the Fund’s in-network negotiated rate and historical allowed amounts for out-of-network charges. The files attached to the links are maintained by the Fund’s third-party administrator Empire. Empire will update the file attached to the links automatically each month.
Here is the link to the machine-readable files:https://www.empireblue.com/machine-readable-file/search.
If you have any questions about the Transparency Rule, you can read more information at https://www.cms.gov/newsroom/fact-sheets/transparency-coverage-final-rule-fact-sheet-cms-9915-f”.