News & Updates

Update: Final Surprise Medical Billing Rules

Are You Prepared for 2023 Enforcements for Transparency in Coverage Compliance?

Following the Federal Departments’ release of the Final Rule on August 19, 2022, additional clarity on the Transparency in Coverage Rule for self-funded health plans outlines expectations for maintaining compliance with upcoming enforcement deadlines. Below are some of the key updates:

Machine-Readable Files Links: Update
The final rule determined for group health plans that do not have their own public site to post machine-readable files, they may enter into a written agreement with a service provider to post the machine-readable files on their behalf.

Self-Service Tool: Update
The final rule determined that the Federal Departments will quarterly update a list of 500 shoppable items beginning January 1, 2023, for the required cost-sharing liability tool members.  The final rule further confirmed the enforcement deadline for the cost-sharing tool remains January 1, 2023, and there will not be any delays.

The effective date for all final rules is October 25, 2022.

You can review all Transparency in Coverage Final Rule information and FAQs by clicking the below.

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