As part of the Transparency in Coverage Rule (CMS-9915-F), issued in 2020 by the U.S. Department of Health & Human Services, U.S. Department of Labor and U.S. Department of the Treasury and enforced beginning 7/1/22, health plans (which include clients who sponsor employee benefit plans) and health insurance issuers must publish two Machine-Readable Files (MRFs):
- In-Network: Negotiated rates for all covered items and services between the plan or issuer and in-network providers
- Out-of-Network: Allowed amount paid to, and billed charges from, out-of-network providers for all covered services within a 90-day period
Accessing MVP’s Machine Readable Files
- To access current and historical MRFs, please click here
The machine-readable files are provided in JSON file format that can be read and processed by a computer system utilizing special software applications.
Each of the files accessible through the Table of Contents is in JSON format and may be as large as one Terabyte (TB) in file size, which has significant system requirements for use. Please ensure you have the required memory capacity, hardware, and software capabilities before attempting to download. As these are provided in compressed folders, you may require the use of a utility to unzip these files from our website; there are numerous free and open-source file archive solutions that can be used to complete that process.
Additional technical guidance from CMS can be found here: GitHub – CMSgov/price-transparency-guide: The technical implementation guide for the tri-departmental price transparency rule.
If you have trouble downloading these files, please contact MVP eSupport at 1-888-656-5695, option 3.