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David Muhlestein, in Health Affairs Scholar
Nov. 12, 2025
"A major challenge with the Transparency in Coverage (TiC) data ... is that many rates relate to providers and groups that do not provide those services.... These negotiated rates -- known as ghost rates -- undermine the goals of transparency data ... Across a combination of all 61 insurers, 91.8% of all the negotiated rates were ghost rates.... To maximize the potential of the TiC data, CMS 8 should require payers to include volume information, allowing users to quickly identify ghost rates."
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