As we have seen in recent months, CMS has started to pick up the pace of hospital audits to ensure Transparency in Coverage (TiC) compliance. Where there was more leniency for noncompliance before as entities worked through the heavy lifting of system implementations to satisfy new requirements, the looming threat of penalty fees in the

If there’s one thing that’s not a secret, it’s that changes to the healthcare system tend to move at a snail’s pace. The Affordable Care Act, for example, took nearly 5 years from the time of its introduction to the first open enrollment period1. Looking on a smaller scale at group health plans, even implementing

Since its founding in 2014, TALON has been ahead of the regulatory curve, setting the standard in a breakthrough market and even influencing the Transparency in Coverage Rule. Our platform was used as an industry standard upon which the new federal mandates were based. TALON provides employers with the tools they need to stay compliant,

Various elements of the Transparency in Coverage Final Rule and the No Surprises Act have already taken effect, and others will take effect over the next two years.  This staged rollout of requirements (with very significant fines for non-compliance) could encourage employers to opt for piecemeal software solutions that end up being far more costly,

The Transparency in Coverage Rule (TiC) already requires that companies post machine readable files (MRF) which disclose negotiated rates for every in-network provider and the historical payments to, and billed charges from, out-of-network providers.  The MRF must also include in-network negotiated rates and historical net prices for covered prescription medications, broken down by health plan

The Implications of Non-Compliance Can Be Dire The phrase “transparency fines are coming” is now a moot point, because—like it or not—transparency fines are here, and enforcement has begun. With the pivotal July 1 deadline to meet the Machine-Readable Files (MRFs) provision of the Transparency in Coverage Rule now behind us, a shocking number of