Final Agenda
NATIONAL COMMITTEE ON VITAL AND HEALTH STATISTICS (NCVHS)
Subcommittee on Standards
Hearing on HIPAA and ACA Administrative Simplification
–Operating Rules, ICD-10, Health Plan ID, Pharmacy Prior Authorization–
Hubert H. Humphrey Building
Department of Health & Human Services
200 Independence Ave, SW, Room 705-A
Washington, DC 20201
Wednesday, February 19, 2014
Agenda
Printable Agenda, Purpose & Background Questions
Transcript
Hearing Purposes, Objectives
The purpose of this hearing is to review and discuss the current status of selected administrative simplification topics that are a priority for NCVHS in 2014.
The objectives of this hearing are as follows:
- Review the status of development of Operating Rules for all remaining HIPAA transactions (Claims, Enrollment, Premium Payment, Prior Authorization, Claims Attachments)
- Discuss the status of initial implementation of Operating Rules for EFT/ERA, which began January 1, 2014
- Review and discuss ICD-10 transition and implementation
- Discuss use of ICD-10 in Workers’ Compensation, Property/Casualty and other non-covered entities
- Review plans for enumerating and use of Health Plan ID
- Review recommendations from DSMO regarding Pharmacy Prior Authorization Standard
| 9:00 – 9:15 am | Welcome and Introductions | Standards Subcommittee Co-Chairs Walter Suarez and Ob Soonthornsima |
| 9:15 – 10:45 am | PANEL 1 – Review of Status Operating Rules EFT/ERA Implementation; ORs for Remaining HIPAA Transactions
|
Gwen Lohse, CAQH Janet Estep, NACHA Heather McComas, AMA Rob Tennant, MGMA Janet Jackson, BCBSNC Stuart Hanson, Citibank |
| 10:45 – 11:00 am | BREAK | |
| 11:00 – 12:30 pm | PANEL 2 – ICD-10: Achieving a Successful Transition
|
Matthew Albright, CMS, OESS John Evangelist, CMS Godwin Odia, CMS (via phone) Jim Daley, WEDI Sid Hebert, Humana Rob Tennant, MGMA Nancy Spector, AMA George Arges, AHA Meryl Bloomrosen, AHIMA Jill Venskytis, PAHCOM Debbie Meisner, Emdeon Tim McMullen, Coop. Exchnage |
| 12:30 – 1:15 pm | LUNCH | |
| 1:15 – 2:15 pm | PANEL 3 – ICD-10 Implementation Beyond Covered Entities
|
Sherry Wilson, Jopari Solutions Tina Greene, Mitchell Intl. Don St Jacques, Jopari Solutions Robert Holden, AAPAN |
| 2:15 – 3:15 pm | PANEL 4 – Pharmacy Prior Authorization
|
Margaret Weiker, DSMO (via phone) Tony Schueth, POCP Lynne Gilbertson, NCPDP Heather McComas, AMA Andrew Morgan, OESS |
| 3:15 – 3:30 pm | BREAK | |
| 3:30 – 4:45 pm | PANEL 5 – Health Plan ID Planning and Implementation Issues
|
Matthew Albright, OESS Chevell Thomas, OESSLaurie Darst Gail Kocher, BCBSA Rob Tennant, MGMA Margaret Weiker, ASC X12 (via phone) Laurie Burckhardt, ASC X12 (via phone) Lynne Gilbertson, NCPDP
|
| 4:45 – 5:00 pm | Public Comments | |
| 5:00 pm | Adjourn |
QUESTIONS FOR PANELISTS
Panel 1 – Operating Rules
- EFT/ERA Implementation (January 1, 2014)
- What is the current status of implementation of EFT/ERA standard and operating rules is there any data? What does this update tell us and what should we/industry be doing in reaction to it? Are there any known implementation issues with the standard and/or operating rules? What are some of the early successes with the adoption of these standards/operating rules?
- Providers:
- What benefits and obstacles of EFT & ERA are you seeing?
- What are the current issues with other payment forms such as virtual cards?
- Development of Operating Rules for all remaining HIPAA transactions (Clams, Enrollment, Premium Payment, Prior Authorization, Claims Attachments)
- What is the status of development of operating rules for all the remaining HIPAA transactions (Please specify for each transaction)
- Are there any priority areas for operating rule consideration with respect to specific transactions?
Panel 2 –ICD-10: Achieving a Successful Transition
- What are the key findings from the latest large-scale industry surveys regarding transition planning and implementation of ICD-10? What do these key findings tell us and what should we be doing in response to these findings?
- What is the current status of testing of ICD-10? What are some of the key initial testing results?
- What should be the industry focus for the remaining 9 months prior to the compliance date?
Panel 3 – ICD-10 Implementation Beyond Covered Entities
- What is the current state of adoption of ICD-10 by property/casualty carriers and workers’ compensation carriers and other HIPAA non-covered entities? What are the perspectives on ICD-10 implementation from TPAs?
- What are the key issues with non-covered entities not adopting ICD-10 after October 1, 2014?
- What are the plans for handling claims with and without ICD-10 codes post October 1, 2014?
Panel 4 – Pharmacy Prior Authorization
- What is the current state of prior authorization transactions within the pharmacy industry?
- What should the relationship be between the e-Prescribing world (including standards development and maintenance) and the HIPAA world?
- What is being recommended by the DSMO with respect to the adoption/use of a new standard for pharmacy prior authorization?
- What are the main benefits for adopting this new standard? What are the key issues or challenges? What is the timeline?
Panel 5 – Health Plan ID Planning and Implementation Issues
- What is the current status of preparation and health plan strategies for adopting the new health plan ID in transactions?
- What is the current status of preparation and plan strategies for using new health plan ID in transactions?
- What are the key issues and challenges with the adoption of a health plan ID and Other Entity Identifier (OEID)? How can these issues be addressed?
- What are the implementation issues/successes with implementing operating rules for TPAs?
- What is the impact on TPAs and ASOs of HPID and Certification of Compliance?
Should you require reasonable accommodation, please contact the CDC Office of Equal Employment Opportunity on (301) 458-4EEO (4336) as soon as possible.
Times, topics, and speakers are subject to change. For final agenda, please call 301-458-4200 at NCHS or visit the NCVHS Home Page at http://www.ncvhs.hhs.gov
February 27, 2014