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