| (a) In-network negotiated rate file schema. For the
"in-network-rates" file published under this subchapter, an issuer
must include data elements consistent with the In-Network File Schema
contained in Machine-Readable Files: Data Schemas (version 1.1), published
on the department's website.
(b) Out-of-network allowed amount file schema. For
the "allowed-amounts" file published under this subchapter, an issuer
must include data elements consistent with the Out-of-Network Allowed
Amount File Schema contained in Machine-Readable Files: Data Schemas
(version 1.1), published on the department's website.
(c) In-network prescription drugs file schema. For
the "prescription-drugs" file published under this subchapter, an
issuer must include data elements consistent with the Rx File Schema
contained in Machine-Readable Files: Data Schemas (version 1.1), published
on the department's website.
(d) Table of contents file schema. If an issuer chooses
to include multiple plans in a single file, as permitted under §21.5502(h)
of this title (relating to Form and Method of Publishing Machine-Readable
Files), the issuer must publish a "table-of-contents" file, consistent
with the Table of Contents File Schema contained in Machine-Readable
Files: Data Schemas (version 1.1), published on the department's website.
(e) Provider reference file schema. If an issuer chooses
to include an external file of provider references, the issuer must
include a "Provider Reference" file, consistent with the Provider
Reference File Schema contained in the Machine-Readable Files: Data
Schemas (version 1.1), published on the department's website.
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