Federal Regulations: Highlights and Recap
Last Friday, August 20, the Departments of Labor, Health and Human Services, and the Treasury (the Departments) issued new frequently asked questions (FAQs) regarding implementation of the Transparency in Coverage (TIC) regulations and the Consolidated Appropriations Act of 2021 (CAA), which includes the No Surprises Act (NSA).
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Transparency in Coverage Rule
The Transparency in Coverage Rule requires hospitals, health insurers and group health plans to provide various pricing files and tools to the public over the course of a multi-year rollout of health care cost data.
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NSA
The Interim Final Rule was issued by the U.S. Office of Personnel Management and the Departments of Health and Human Services, Labor, and Treasury on July 1, 2021 and takes effect January 1, 2022.
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Interim Final Rule
The first interim final rule explaining how to implement provisions of the No Surprises Act (NSA) was released by the Biden administration on Thursday, July 1, 2021.
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Federal Legislation for Self-Funded Health Plans
WebTPA is committed to keeping its clients up to date on federal healthcare policies and legislation. Here you will find our interpretation of said legislation and how these statutes may impact your health plan.
Publicly Available, Machine-Readable Files
In-Network Rates and Historical Out-of-Network Allowed Amounts
To meet transparency requirements effective July 1, 2022, WebTPA will assist plan sponsors in making the two machine-readable files available (in-network rates for covered services or item covered by the plan, historical billed charges from out-of-network providers and the allowable amount of such charges considered by the plan).
Important Note
These are very large JavaScript Open Notation (JSON) files (20GB to 70GB) that may take a while to download. If your system has limited capability, they may not be downloadable. Download speeds and time are dependent on your internet speed, browser and computer hardware.
