Transparency In Coverage
Machine Readable Files Portal
CMS-9915-F Machine Readable Files
Auxiant is an independent third party administrator of self funded health plans specializing in customization, cost-control, health management, and technological tools for our clients and members.
Our clients, who are plan sponsors, contract with regional and national Preferred Provider Organizations (PPOs) and Pharmacy Benefit Managers (PBMs) for negated rates with hospitals, doctors, clinics, and prescription drug distributers.
We have created this portal as a service to those plan sponsors, PPOs, and PBMs, to host the machine readable files that plans are required to publicly provide to facilitate the transparency in coverage rule as mandated by federal law (https://www.federalregister.gov/documents/2020/11/12/2020-24591/transparency-in-coverage).
The files provided here contain in-network negotiated payment rates and historical out-of-network charges for covered items and services, including prescription drugs in machine readable file formats as required by CMS-9915-F (https://www.cms.gov/CCIIO/Resources/Regulations-and-Guidance/Downloads/CMS-Transparency-in-Coverage-9915F.pdf). These files are independently generated, maintained, and uploaded to this portal by the PPOs and PBMs who negotiate and manage these contracted rates on behalf of plan sponsors. CMS sample file formats are provided at https://github.com/CMSgov/price-transparency-guide.