Transparency in Coverage Raw Data Files Can Ensure Employer Health Plans Are Paying Fair Prices

Self-insured employers have a new tool to ensure they are paying fair prices for medical services. The Consolidated Appropriations Act, 2021 (CAA) established protections for consumers related to surprise billing and transparency in health care. It created a unique opportunity by establishing the Transparency in Coverage (TiC) requirements, making available all negotiated prices from every healthcare payer to every medical provider for every service in the U.S., beginning in the latter half of 2022, updated monthly. These rules provided unprecedented access to proprietary price information.