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.
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.
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.
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).