Administration releases new FAQ on Transparency in Coverage regulations

The Administration yesterday released a new FAQ on Transparency in Coverage regulations effective July 1 that require health plans to release machine-readable files of their in-network negotiated rates and out-of-network allowed amounts. According to the FAQ, the Administration will provide an enforcement safe harbor when plans using alternative reimbursement arrangements cannot accurately derive a specific dollar amount until after a service is rendered, for example, in percent-of-billed charges contract arrangements. In such cases, the plan can list the formula, methodology or other information about how the rate would be derived, instead of a specific dollar amount, the FAQ states.