Aspirus is committed to supporting the Transparency in Coverage Rule by making Machine Readable files (MRFs) available for our customers. Centers for Medicare & Medcaid Services (CMS) will start to enforce the regulatory requirements for Machine-Readable files under the Transparency in Coverage Rule for plan years on and after 1/1/2022.
The Transparency in Coverage Rule requires public disclosure of negotiated in-network provider rates and out-of-network allowed amount and bill charges for items and services covered by a health plan/policy. We are not providing data for out-of-network providers with fewer than 20 claims. The third machine-readable file for drug pricing information has been deferred until further guidance is provided.
The Machine-Readable files are posted below. The MRF files are not the cost comparison tool. Cost comparison is scheduled for 2023 for the 500 shoppable items, services and drugs in the final rule.
Additional information will be made available on this page.
Access Machine Readable Files (MRF) Here