Compliance

Price Transparency Regulation & Legislation

Jan 1, 2021

Hospital Price Transparency Rule

Requires hospitals to publish their MRF and Patient Estimate Tool.

Jan 1, 2022

No Surprises Act (NSA)

Requires accurate, up-front Good Faith Estimates and Advanced EOBs.

Jul 1, 2022

Transparency In Coverage Part I

Requires payers to publish their MRF.

Jan 1, 2023

Transparency In Coverage Part II

Requires payers to publish a Patient Estimate Tool.

Jul 1, 2024

CY 2024 OPPS Final Rule

Requires hospitals to adopt a new standard schema, data elements, and more.

Introduced

PRICE 2.0 Act

If passed, the bill would codify and expand on the existing price transparency mandates into law.

Introduced

Lower Costs, More Transparency Act

If passed, the bill would require hospitals, payers, labs, imaging centers, and ASCs to disclose cost sharing information.

Jan 1, 2025

Drug Reporting Requirement for Hospitals

Mandates hospitals to publish a machine-readable file (MRF) containing the detailed drug information for all drugs within the hospital’s chargemaster.

MRF Generation Process

We could say easy things like “MRFs with the push of a button” but, instead, here’s what file creation actually looks like.

Step 1 - File ingestion

Upload all relevant files via SFTP server or directly onto the platform.

Step 2 - Stage & Generate

Our algorithm prices each charge according to the correct contract rate and formats to CMS standards.

Step 3 - Publish & QA

Hit "Publish" and deploy automated data checks and manual QA to ensure no code is out of place.

Featured Content

Drug Pricing & Reimbursement Infusion Confusion in 2025

In this blog, we’re focused on understanding provider sensitivity to drug contracting mechanisms and how markups influence reimbursement.

Reimbursement Structure Trends & What They Mean for Providers

Let’s add “business intelligence" into the Price Transparency Cinematic Universe.

Can price transparency data replace claims data?

Survey says….

A Price Transparency Resource Hub

TQU is for everyone and anyone looking to learn about price transparency legislation, regulations, compliance, and data. Written and fact-checked by the Turquoise Health team, we've compiled this resource to help you learn all you need to know about Price Transparency in Healthcare. You're welcome.

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