CMS issues late, breaking guidance on posting machine-readable files 

June 22, 2022

With the July 1 deadline looming for many group health plans to post machine-readable files (MRFs) on the plan’s public website, the Centers for Medicare and Medicaid Services (CMS) issued a new FAQ that some plan sponsors will find helpful. Specifically, the FAQ allows group health plans that do not have a public website to satisfy the requirements of the Transparency in Coverage (TiC) rules to post Out-of-Network Allowed Amount and In-Network MRFs by entering into a written agreement with a service provider (like a third-party administrator) to post the MRFs on their public website on behalf of the plan. If, however, the service provider does not abide by the terms of the written agreement and fails to post the MRFs, the plan (not the service provider) would violate the TiC rules.

This raises a number of questions for plan sponsors to consider and review with legal counsel:

1. Does the group health plan have what might reasonably be considered a public website? If it does, then this FAQ relief is not applicable, and the plan must post a link to the MRFs on its public website.

2. If the plan does not have a public website, does (or will) the plan have a written agreement in place with service providers to post the MRFs on the service provider’s public website, and is the agreement legally adequate?

3. Many plans have been preparing to post links on the company’s public website (perhaps on a Career or Employment site) to service provider websites where the MRFs will be posted. Should the plans continue with this strategy to post those links, pending additional guidance from the regulators? The answer to this may turn on whether the plan feels it has what would be considered a plan public website under the TiC rules and forthcoming guidance.

It may be too late for many plan sponsors to change course now, but this guidance will be very helpful to those that objectively don’t have a plan public website and already have a written agreement in place with a vendor that is posting the MRFs on their behalf. Plan sponsors that want to proceed without adding to the company’s website MRF links that lead to a vendor’s website should review this guidance carefully with counsel.

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