CMS plans a new enforcement timeline for the updated Transparency in Coverage (TiC) schema, giving payers four months to comply. This is the first major schema change since the mandate took effect in 2022, and it represents a massive change to the status quo. While this may sound like a technical adjustment, it represents a meaningful step forward in making price transparency data more usable and actionable for providers and health systems.
What’s Changing
The updated schema introduces several important improvements:
- Consolidation of redundant fields to shrink machine-readable files (MRFs) and reduce noise.
- Clearer identifiers, such as payer business names alongside EINs, to improve mapping accuracy.
- Standardization of severity-related fields, helping explain why some services cost more.
- Streamlined location files to reduce complexity and ease data ingestion.
- Cleaner separation of payer and plan sponsor fields, improving visibility in large group markets.
Currently, these MRFs are clunky and intentionally hard to interpret: insurance companies don’t want you to be able to utilize this data. However, these clear expectations will force commercial payers to show their hand, which is a big win for providers.
Why This Matters For Providers
This amendment to policy will be enacted on February 2, 2026, meaning that providers have a short window to prepare. Those who invest early in tools and processes to interpret the new schema will be able to benchmark rates, identify inequities, and negotiate from a position of strength. By being ahead of the curve with actionable data, providers position themselves to shape contracts on their terms instead of reacting to payer defaults.
Trek Health’s Perspective
Trek Health is ready for these changes - we are poised to ingest and process the new MRF schema immediately upon payer publication. This update transcends just regulatory compliance, it represents a real win for healthcare providers to push for more equitable rates. When data improves, so does negotiating power. With this update, providers have the strategic opportunity for contract realignment: they must seize it now to secure fairer rates, recover lost revenue, and position themselves ahead of the market shift. For providers who act now, this is far greater than political jargon, it is leverage to drive real change in payer negotiations.
