Comment period

Tools & Resources for Letter Submissions

drogers@caqh.org — Wed, 16 Nov 2022 14:55:39 +0000

Tools & Resources for Letter Submissions drogers@caqh.org Wed, 11/16/2022 - 09:55

CAQH CORE Resources

CAQH CORE Board Letter to NCVHS: In its May 2022 letter requesting review of the proposed operating rules to NCVHS, the CORE Board outlines its rationale for supporting federal adoption and value of the new and updates rules.

Proposed Operating Rules Cheat Sheet : This document provides a side-by-side comparison of requirements in the currently mandated operating rules with the proposed updated versions, outlines new rule requirements, and highlights the benefits of the proposed rules.

Coming Soon! RFC Guidance Document: This document summarizes the questions posed by NCVHS in the RFC and provides guidance on how to approach responses including relevant operating rule information and impact.

CAQH CORE Board Chairs’ Blog Post: Timothy Kaja, President, Networks & Network Support, Optum Health; Immediate Past Chair, CAQH CORE Board and Linda Reed, Senior Vice President and Chief Information Officer, St. Joseph’s Health; Chair, CAQH CORE Board share their thoughts on the value of the proposed rules.

Relevant Past CAQH CORE Webinars
- The Value of Standardization and Automation, a conversation with CAQH CORE Board Member Margaret Schuler – Slides PDF (11/03/22)
- Eligibility & Benefits Standards and Operating Rules, a Joint webinar with CAQH CORE and X12 – Slides PDF (07/11//22)
- New CAQH CORE Operating Rules – Slides PDF (04/27/22)
- New CAQH CORE Operating Rules to Improve Patient Attribution Data Sharing and Connectivity – Slides PDF (02/16/21)
- CAQH CORE Connectivity Operating Rules – Slides PDF (07/22/20)

CAQH Program

CORE

Status

Comment period

Proposed Operating Rules

drogers@caqh.org — Wed, 16 Nov 2022 14:50:34 +0000

Proposed Operating Rules drogers@caqh.org Wed, 11/16/2022 - 09:50

Earlier this year the CAQH CORE Board unanimously approved a set of new and updated CAQH CORE Operating Rules to bring forward for federal mandate. On May 23^rd, 2022 the Board submitted a letter to NCVHS that formally requested review of the new and updated rules for federal adoption. The letter outlines the Board’s rationale for supporting the proposed ruleset.

The proposed set of new and updated CAQH CORE Operating Rules include:

Updated: Federally Mandated Infrastructure Rules
Updated: Connectivity Rule vC4.0.0

NCVHS will review industry feedback on the proposed operating rules via comment letters and the industry hearing on January 18 and 19, 2023 to inform a recommendation to the Secretary of HHS on federal adoption. Please see the resources and tools below for more detail on the proposed operating rule requirements, updates from prior mandated versions, and benefits of adoption.

CAQH Program

CORE

Status

Comment period

NCVHS Request for Comments on Proposed Operating Rules

drogers@caqh.org — Wed, 16 Nov 2022 14:44:40 +0000

NCVHS Request for Comments on Proposed Operating Rules drogers@caqh.org Wed, 11/16/2022 - 09:44

Due December 15^th, 2022

On November 1^st, 2022 the Standards Subcommittee of the National Committee on Vital and Health Statistics (NCVHS), a federal advisory committee to the Secretary of HHS, published a notice in the Federal Register announcing that a Hearing on Requests for New and Updated Transaction Standards and Operating Rules will be held on January 18^th and 19^th, 2023.

NCVHS is inviting industry stakeholders to provide written comments via a Request for Comment (RFC) on the value of the proposed standards and operating rules.

To submit please send comment letters to NCVHSmail@cdc.gov with subject line: RFC on X12 and CAQH CORE Proposals by December 15, 2022.

To support comment letter development, CAQH CORE has compiled key resources on the proposed operating rules for industry reference. Please click below to access links to all proposed rules, background material, webinars, and tools including a crosswalk between currently mandated and proposed operating rules.

If you have any questions or require any additional support as you review the proposed rules, please reach out to CORE@caqh.org.

In the video below, Erin Weber, CAQH CORE Vice President, and Bob Bowman, Principal of Interoperability and Standards at CAQH, provide a brief overview of the regulatory process for operating rule adoption, present a summary of the proposed rules, and address frequently asked questions.

more information on the proposed operating rules

The proposed set of new and updated CAQH CORE Operating Rules include:

Updated: Federally Mandated Infrastructure Rules

Updated: Connectivity Rule vC4.0.0
Updated: Eligibility & Benefits (270/271) Data Content Rule vEB.2.0
New: Eligibility & Benefits (270/271) Single Patient Attribution Data Content Rule vEB.1.0
New: Attachments Operating Rules

tools and resources

CAQH CORE Board Letter to NCVHS: In its May 2022 letter requesting review of the proposed operating rules to NCVHS, the CORE Board outlines its rationale for supporting federal adoption and value of the new and updates rules.

Proposed Operating Rules Cheat Sheet: This document provides a side-by-side comparison of requirements in the currently mandated operating rules with the proposed updated versions, outlines new rule requirements, and highlights the benefits of the proposed rules.

CAQH CORE Connectivity Rule Comparison: This document specifically compares requirements in the federally mandated Phase I CORE 153: Eligibility and Benefits Connectivity Rule and Phase II CAQH CORE 270: Connectivity Rule to updates made in CAQH CORE Connectivity Rule vC4.0.0.

NCHVS CAQH CORE Operating Rule Implementation Survey Tool: This document helps organizations understand the impact, costs, and benefits of implementing operating rules. This tool provides a high-level framework to gather estimates of the resources required for operating rule implementation, assess savings opportunities, and assign value scores across the advantages that rules could afford for your organization.

NCVHS RFC Guidance Document: This document summarizes the questions posed by NCVHS in the RFC and provides guidance on how to approach responses including relevant operating rule information and impact.

CAQH CORE Board Chairs’ Blog Post: Timothy Kaja, President, Networks & Network Support, Optum Health; Immediate Past Chair, CAQH CORE Board and Linda Reed, Senior Vice President and Chief Information Officer, St. Joseph’s Health; Chair, CAQH CORE Board share their thoughts on the value of the proposed rules.

Relevant Past CAQH CORE Webinars
- The Value of Standardization and Automation, a conversation with CAQH CORE Board Member Margaret Schuler – Slides PDF (11/03/22)
- Eligibility & Benefits Standards and Operating Rules, a Joint webinar with CAQH CORE and X12 – Slides PDF (07/11//22)
- New CAQH CORE Operating Rules – Slides PDF (04/27/22)
- New CAQH CORE Operating Rules to Improve Patient Attribution Data Sharing and Connectivity – Slides PDF (02/16/21)

CAQH Program

CORE

Status

Comment period

Comment period

Tools & Resources for Letter Submissions

CAQH CORE Resources

Proposed Operating Rules

NCVHS Request for Comments on Proposed Operating Rules

Due December 15th, 2022

more information on the proposed operating rules

tools and resources

Due December 15^th, 2022