Standards Subcommittee Meeting

Hearing on Request for NCVHS Review of CAQH CORE Operating Rules for Federal Adoption

August 25-26, 2020

Please check back closer to the meeting date for the virtual connection information.

 

Tentative 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
10:20 a.m. Overview of HHS authority to adopt operating rules Division of National Standards (HHS/CMS) Dan Kalwa, CMS
10:35 a.m. Overview of proposed operating rules for prior authorization and connectivity CAQH CORE
11:15 a.m. Intersection of standards and operating rules X12
11:40 a.m. Break  
11:50 a.m. Health Plan perspective on proposed prior authorization operating rules (Panel 1A) America’s Health Insurance Plans (AHIP) Anthem (invited)

Blue Cross Blue Shield Association (BCBSA) Kaiser Permanente (invited)

12:45 p.m. Lunch  
1:45 p.m. Health Plan perspective on proposed prior authorization operating rules (Panel 1B) CMS Medicare Fee-For-Service Program North Dakota Medicaid (invited)

United Health Care (invited)

2:30 p.m. Provider perspective on proposed prior authorization operating rules (Panel 2A) American Dental Association (ADA) (invited) American Hospital Association (AHA) American Medical Association (AMA) Department of Defense (DoD) (invited)
3:15 p.m. Break  
3:25 p.m. Provider perspective on proposed prior authorization operating rules (Panel 2B) Medical Group Management Association (MGMA)

Montefiore Medical (invited)

Ohio Health

Veterans Health Administration (VHA) (invited)

4:15 p.m. Vendor & Clearinghouse perspective on proposed prior authorization operating rules Availity (invited)

Cooperative Exchange (invited)

Electronic Health Records Association (EHRA)

(invited)

Healthcare Billing and Management Association (HBMA)

5:05 p.m. Public Comment on proposed prior authorization operating rules Rebecca Hines

Executive Secretary/DFO

5:20 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

10:10 a.m. Vendor Perspective on proposed connectivity operating rule Availity (invited)

Cooperative Exchange (invited)

Electronic Health Records Association (EHRA) (invited)

Healthcare Billing and Management Association (HBMA)

11:00 a.m. Provider Perspective on proposed connectivity operating rule

(with a break)

American Dental Association (ADA) (invited)

American Hospital Association (AHA)

American Medical Association (AMA)

Department of Defense (DoD) (invited)

Medical Group Management Association (MGMA)

Montefiore (invited)

Ohio Health

Veterans Health Administration (VHA) (invited)

12:45 p.m. Lunch  
1:30 p.m. Health Plan perspective on proposed connectivity operating rule America’s Health Insurance Plan (AHIP)

Blue Cross Blue Shield Association (BCBSA)

Kaiser Permanente (invited)

North Dakota Medicaid (invited)

United Health Care (invited)

2:30 p.m. Public Comment Rebecca Hines

Executive Secretary/DFO

2:50 p.m. Closing Remarks Alix Goss and Rich Landen

Co-chairs, Subcommittee on Standards

3:00 p.m. Adjourn Alix Goss and Rich Landen

Co-chairs, Subcommittee on Standards

 

Each presenter has 7 minutes; each panel includes approximately 15-20 minutes of Q&A with Subcommittee members

Upcoming NCVHS Meetings

  • Full Committee, November 18-19, 2020