Transparency in Coverage
As part of the Consolidated Appropriations Act (CAA), new Transparency in Coverage rules have been established by the Centers for Medicare & Medicaid Services (CMS), including a multi-year initiative that requires health plans to share contracted prices for all health care items and services. The first phase of these requirements begins July 1, 2022.
To comply with the Transparency in Coverage rule, as a self-funded employer group, EFPR Group will provide a link to the Univera website where the following information will be available.
• In-network provider contracted rates for items and services
• Out-of-network allowed amounts and billed charges for items and services