By July 1, 2022, insurers and self-funded group health plans must begin to publicly post Machine Readable Files (MRFs) including:
1. Negotiated rates for a health plan’s in-network providers in-network providers
2.Historical allowed amounts and billed charges for out-of-network providers
If an Optima Health medical plan includes dental, chiropractic, vision, or other integrated benefits, data included in the MRFs. A third file that requires posting of negotiated rates and historical net prices for prescription drugs, that was a requirement of the original rules, has been delayed until additional regulations are finalized.
Data in MRFs must be available to the public without a requirement to log in to a website or provide any member specific information. The MRFs will be publicly available for the current month only. The data can be accessed through the link below.