The Transparency in Coverage mandate requires insurers and group health plans to make rate information publicly accessible to members and non-members starting July 2022.
Medical Mutual will share rate information for Medical Mutual-contracted providers as well as historical allowed amounts and billed charges for out-of-network providers in a machine-readable file (MRF) format. The information will be posted on a dedicated MRF landing page, accessible through MedMutual.com.
To be considered compliant under the mandate, the regulations specify that ASO groups must include a link on their own website that directs users to the location of the publicly available MRFs. Here is where we’ll provide access to the files:https://www.medmutual.com/For-Employers/Employer-Resources/No-Surprises-Act-Legislation.aspx
In addition, MMO has created a web page to help employer groups, members and brokers understand this legislation and the steps we’re taking to comply. Feel free to share the link with clients who have questions. However, it’s not something we’ll actively promote. The page, titled No Surprises Act/Transparency https://www.medmutual.com/For-Employers/Employer-Resources/No-Surprises-Act-Legislation.aspx Under the Consolidated Appropriations Act, 2021, can be found under the Employer Resources tab on the https://www.medmutual.com/For-Employers.aspx .
The web page outlines different pieces of the legislation and the steps Medical Mutual is taking (or will take) to comply with the legislation. Below are the topics you’ll find addressed on the site. We’ll update the information and add additional content as it becomes available.
- Advanced EOBs
- Continuity of Care
- Cost Comparison Tool
- Machine-Readable Files
- Member Disclosures
- Member ID Cards
- Mental Health Parity and Non-Quantitative Treatment Limitation (NQTL)
- Payment Disputes & Resolution
- Provider Directories