MRF Technology.
Our algorithm takes your payer-negotiated rates to produce files in compliance with the new CMS standardized template (effective July 2024).
Accurate and Complete.
We model the negotiated rates from your managed care agreements through our Clear Contracts platform, ensuring no coverage gaps.
Transparent Access.
Access your price transparency files and underlying data anytime.
Final MRF changes.
New regulations and requirements from the CY 2024 OPPS and ASC Final Rule.
New data elements.
Further define each charge and separately list additional metadata about the file and hospital.
Hospital providers who proactively included this data in their MRFs should still parse out fields like plan names and drug units/measurements across their datasets.
Additional header row.
MRFs must include the hospital name/info, versioning, financial aid policy, and hospital licensure number.
Additional charge details.
MRFs must disclose code types, separate plan names, and contracting methods. Drug and modifier details will be required as of 1/1/2025.
Additional file accessibility.
Hospital websites must include a .txt file in the root folder with a direct link to the MRF and a link in the website footer directing users to the MRF landing page.
Resources.
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CMS
The Final Rule
Nov 22, 2023
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Turquoise Health
CMS Releases New Final Rule with Required Schemas for Hospital MRFs
Nov 2, 2023
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CMS
The Final Rule CMS Press Release
Nov 2, 2023
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CMS
Hospital Price Transparency Fact Sheet
Nov 2, 2023
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Turquoise Health
Turquoise Health Comments on the 2024 OPPS Proposed Rule
Oct 3, 2023
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Turquoise Health
Top 10 Things Hospital CEOs Should Know About the CMS OPPS Proposed Rule
Jul 18, 2023
New data validation rules.
Data validation rules for new and existing fields will allow for true standardization of price transparency data.
This change will drastically improve the industry’s ability to serve accurate information to consumers, but every provider will be impacted.
Additional estimated allowed field.
Consumer-friendly dollar amount is now required from formulaic rates.
Standard values.
No more questions about IP vs. Inpatient or MSDRG vs. MS-DRG: CMS is mandating specific values for several fields.
Verified accuracy.
CMS takes the guesswork out by requiring hospitals to clearly state the date the MRF data was most recently updated.
Accepted formats.
CMS requires hospitals to post MRFs in one of three format and layout options. Hospitals can select the least burdensome option based on their MRF development process.
Tall CSV.
Simpler maintenance and efficient data storage thanks to multiple rows for a given charge and one set of columns for payer/plan name.
Wide CSV.
Easier analysis without technical tools thanks to one row for each charge and additional columns for each Payer/Plan name.
JSON schema (plain format).
Most explicit since it allows for the storage of hierarchical and relational data in a plain text format.