Hospital MRF Update

Breaking news: CMS to enforce a standard hospital MRF format as of March 1st, 2024.

Turquoise helps hospital providers stay in compliance with newly released CMS machine-readable file requirements around new data elements, data validation, and file structure.


Gap Assessment.

Contact us for a free assessment of your current machine-readable files.

MRF Reformat.

If all required data is present in your existing MRF, we can reformat your files to meet the new standard without changing your pipeline.

MRF Management.

With Clear Contracts integration, we can create, re-format, and monitor your machine-readable files.

MRFs are changing.

Learn more about the new requirements in the CY 2024 OPPS/ASC proposed rule that will impact all hospital providers.

New General Elements.

Hospital name, licensure #, file version, and update date.

Additional Charge Details.

Code Types, Drug and Modifier Details, Separate Plan Names, Contracting Methods.

New Data Elements.

CMS now requires hospitals to further define information about each charge, and to separately list additional metadata about the file and hospital.

Even hospital providers who proactively included this data in their MRFs will want to parse out fields like Plan Name and Drug Units/Measurements across their datasets

New Data Validation Rules.

Data validation rules for new and existing fields are being added to 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 to some degree (at Turquoise we call this Type 2 fun).

New Expected Allowed Field.

Consumer friendly dollar amount 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.

New Accepted Formats.

The new rule mandates hospitals to conform to one of three file formats, all of which are supported by Turquoise Health’s Compliance+ product. Let us demystify these for you.

Tall CSV.

Simpler maintenance and efficient data storage - multiple rows for a given charge, one set of columns for Payer/Plan name.

Wide CSV.

Easier analysis without technical tools - one row for each charge, additional columns for each Payer/Plan name.

Plain (JSON).

Most explicit - allows for storage of hierarchical and relational data in a plain text format.

Turquoise Resources