Machine-Readable Files

Delivering greater cost transparency

As part of the Transparency in Coverage Final Rule set forth by the U.S. Department of the Treasury, the U.S. Department of Labor, and the U.S. Department of Health and Human Services (referred to collectively as the “Tri-Agencies”), group health plans and health insurance issuers are required to make available to the public negotiated rates for all covered items with in-network providers, and historical payments to and billed charges from, out-of-network providers through machine-readable files (MRFs) posted on an internet website, updated monthly. These files will permit the public to have access to health plan payment information that can be used to understand health plan pricing and the cost for health care services.

The files that are posted will include:

  • In-network provider negotiated rate files
  • Out-of-network provider historic allowed amount files 
  • Table of Contents files

File format

To ensure data integrity, all files must conform to a non-proprietary, open standard format, like JSON, XML or YAML, and be made available via HTTPS. The content of the files is formatted to technical standards in guidance published by the Centers for Medicare & Medicaid Services (CMS).  See CMS Technical Guidance for reference.

Tufts Health Plan will publish machine-readable files in the JSON format to its website on or around the first day of every month.

Access the machine-readable files

Tufts Health Plan will generate machine-readable files for its various plans and group health plan clients. From the “View Plan List” link below you can choose the plan for which you wish to access machine-readable files.

View Plan List


Questions & answers