CMS Clarifies TiC “Public Website” Requirement

UPDATE

The Transparency in Coverage Rule (TiC) includes a provision that requires self-insured employer-sponsored health plans to include a link to the files containing the pricing data on a public website.  This requirement was puzzling and problematic for many employers simply because they do not maintain a public website for their plans. CMS has recently posted the following technical clarification to the requirement that plans post a link to TiC data on a public website:

Question #37:

May a group health plan that does not have its own website satisfy the requirements of the TiC Final Rules with respect to posting the Allowed Amount file and the In-network Rate file on a public website of the plan, if the plan’s service provider posts the Allowed Amount file and the In-network rate file on its public website on behalf of the group health plan? (New 6/17/22)

Answer #37:

A. If a group health plan does not have a public website, the plan may satisfy the requirements for posting the Allowed Amount file and the In-Network file by entering into a written agreement under which a service provider (such as a TPA) posts the Allowed Amount file and the In-network Rate file on its public website on behalf of the plan.

B. However, if a plan enters into an agreement under which a service provider agrees to post the Allowed Amount file and the In-network Rate file on its public website on behalf of the plan, and the service provider fails to do so, the plan violates these disclosure requirements. The Departments intend to follow up with the issuance of formal guidance soon.

Employers who wish take advantage of this clarification should promptly contact their TPAs or other service providers to include posting the required link among their contractually required services. Additionally, employers need to monitor service providers to ensure compliance with the rule.