№ lp_1_28232
File format: docx Character count: 20087 File size: 289 KB
Federal regulatory guidance describing required content and structure of machine-readable files for disclosure of negotiated in-network rates and historical out-of-network allowed amounts under U.S. health insurance transparency rules.
Year: 2022
Effective date: July 1, 2022
Jurisdiction: United States
Subject: Health insurance price transparency
Document type: Technical guidance
Issuing bodies: Department of Labor; Department of Health and Human Services; Department of the Treasury
Regulatory basis: Transparency in Coverage Final Rules
Related legislation: Patient Protection and Affordable Care Act; Public Health Service Act
Covered entities: Non-grandfathered group health plans and health insurance issuers
Scope: In-network provider rates; out-of-network allowed amounts and billed charges
Referenced publication: Federal Register, November 12, 2020
Implementation resources: GitHub
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SECTION 1 – OUT-OF-NETWORK USE
Note: Year
Out-of-Network Benefits Rider
Note: Year
Theme: Health Insurance
Document Type: Rider
Target Audience: Policyholders
Topics: In-Network Machine-Readable Out-of-Network