Standards Subcommittee Meeting
Hearing on Request for NCVHS Review of CAQH CORE Operating Rules for Federal Adoption
August 25-26, 2020
Agenda
Tuesday, August 25
| Time | Panel | Participants |
| 10:00 a.m. | Welcome, Call to Order | Rebecca Hines
Executive Secretary/Designated Federal Officer |
| 10:05 a.m. | Opening Remarks/Agenda Review | Alix Goss and Rich Landen, Co-Chairs Subcommittee on Standards |
| 10:10 a.m. | New proposed operating rules submitted to NCVHS from CAQH CORE | Alix Goss and Rich Landen, Co-chairs |
| 10:30 a.m. | Overview of HHS authority to adopt operating rules | National Standards Group, HHS/CMS
Dan Kalwa, CMS |
| 10:45 a.m. | Overview of proposed operating rules for prior authorization and connectivity | April Todd, CAQH CORE
Susan Turney, Marshfield Clinic Health System Timothy Kaja, UnitedHealthcare |
| 11:25 a.m. | Intersection of standards and operating rules | Cathy Sheppard, X12 |
| 11:50 a.m. | Break | |
| 12:00 p.m. | Patient Perspective | Anna Hyde, Arthritis Foundation |
| 12:20 p.m. | Health Plan perspective on proposed prior authorization operating rules (Panel 1A) | Christol Green, Anthem
Cathy Plattner, Kaiser Permanente |
| 12:50 p.m. | Lunch | |
| 1:50 p.m. | Health Plan perspective on proposed prior authorization operating rules (Panel 1B) | Connie Leonard, CMS Medicare Fee-For-Service
Gail Kocher, BCBSA |
| 2:20 p.m. | Provider perspective on proposed prior authorization operating rules (Panel 2A) | Terry Cunningham, AHA
Heather McComas, AMA Robert Tennant, MGMA |
| 3:00 p.m. | Break | |
| 3:15 p.m. | Provider perspective on proposed prior authorization operating rules (Panel 2B) | Noam Nahary and Stephen Rosenthal, Montefiore Medical
Margaret Schuler, Ohio Health Katie Knapp, Veterans Health Administration |
| 3:55 p.m. | Vendor & Clearinghouse perspective on proposed prior authorization operating rules | Paul Joiner, Availity
Sherry Wilson, Cooperative Exchange Hans Buitendijk, EHRA Arthur Roosa, HBMA |
| 4:45 p.m. | Public Comment on proposed prior authorization operating rules | Rebecca Hines
Executive Secretary/DFO |
| 5:00 p.m. | Closing and Adjourn | Alix Goss and Rich Landen
Co-chairs, Subcommittee on Standards |
Wednesday, August 26
| Time | Panel | Participants |
| 10:00 a.m. | Welcome, Call to Order | Rebecca Hines
Executive Secretary/Designated Federal Officer |
| 10:05 a.m. | Welcome and Review Agenda | Alix Goss and Rich Landen, Co-Chairs
Subcommittee on Standards |
| 10:15 a.m. | Vendor Perspective on proposed connectivity operating rule | Paul Joiner, Availity
Sherry Wilson, Cooperative Exchange Hans Buitendijk, EHRA Arthur Roosa, HBMA |
| 11:00 a.m. | Provider Perspective on proposed connectivity operating rule
(with a break) |
Terry Cunningham, AHA
Heather McComas, AMA Robert Tennant, MGMA Noam Nahary and Stephen Rosenthal, Montefiore Margaret Schuler, Ohio Health |
| 12:00 p.m. | Lunch | |
| 1:00 p.m. | Health Plan perspective on proposed connectivity operating rule | Gail Kocher, BCBSA
Cathy Plattner, Kaiser Permanente Christol Green, Anthem |
| 1:25 p.m. | Public Comment | Rebecca Hines
Executive Secretary/DFO |
| 1:35 p.m. | Clarifying Questions for CAQH CORE | Subcommittee Members with April Todd, CAQH CORE Bob Bowman, CAQH CORE |
| 2:10 p.m. | Closing Remarks | Alix Goss and Rich Landen
Co-chairs, Subcommittee on Standards |
| 2:15 p.m. | Adjourn | Alix Goss and Rich Landen
Co-chairs, Subcommittee on Standards |
Upcoming NCVHS Meetings
- September 14, 2020, Hearing of the Subcommittee on Privacy, Confidentiality and Security
- November 18-19, 2020, Full Committee