Transparency in Coverage Compliance
Friday, July 1, 2022
This Fund is required to provide certain information on a public website pursuant to the Federal Transparency in Coverage Final Rule published in the Federal Register on November 12, 2020.
This 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 this Fund and others to better understand the health care system and its costs and, hopefully, create new policies that improve competition and lower health care spending.
The 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 (PHI) about you or your family.
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 behind the links are maintained by the Plan’s third party administrators, Empire Blue Cross Blue Shield for hospital/medical coverage, and Optum for behavioral health coverage. The files behind the links will be updated automatically each month by the third party administrators.
If you have any questions about the Rule, you can read more information at https://www.cms.gov/newsroom/fact-sheets/transparency-coverage-final-rule-fact-sheet-cms-9915-f