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The Implementation Deadline for Federally-mandated CAQH CORE EFT and ERA Operating Rules was January 1, 2014.
Learn more about CAQH CORE resources available to help your organization meet the Patient Protection and Affordable Care Act's operating rule mandate.


CORE Overview Presentation


CORE Provider Presentation

Voting Process for CAQH CORE Operating Rules


*CAQH CORE BodyCAQH CORE Requirements for Rules Approval
Level 1:

CAQH CORE Subgroups
Not addressed in governing procedures, but must occur to ensure consensus building.
Level 2:

CAQH CORE Work Groups
Work Groups require for a quorum that 60% of all organizational participants are voting. Simple majority vote (greater than 50%) by this quorum is needed to approve a rule.
Level 3:

Full CAQH CORE Voting Membership
Full CORE Voting Membership vote requires for a quorum that 60% of all Full CORE Voting Member organizations (i.e., CORE Participants that create, transmit, or use transactions) vote on the proposed rule at this stage. With a quorum, a 66.67% approval vote is needed to approve a rule.
Level 4:

CAQH CORE Board
The CAQH CORE Board's normal voting procedures would apply. If the Board does not approve any proposed Operating Rule, the Board will issue a memorandum setting forth the reasons it did not approve the proposed Operating Rule and will ask the CORE Subgroups and Work Groups to revisit the proposed Operating Rule.

*NOTES:
CAQH Board/CAQH does not have veto or voting power over the CAQH CORE Operating Rules.
Any entity that is a CAQH CORE Participant per the CAQH CORE application process has a right to vote on the rules, understanding that at Level 3 only entities that will implement the rules vote on the rules.