Administrative Simplification News: Health Plan Certification of Compliance Comment Period

Health Plan Certification of Compliance Proposed Rule Comment Period The Department of Health and Human Services (HHS) has issued a new proposed rule for public comment, “Administrative Simplification: Health Plan Certification of Compliance.” Certification of compliance is mandated by section 1104 of the Affordable Care Act that requires health plans to file a statement with HHS certifying that they are in compliance with the standards and operating rules. HHS is accepting public comments on the proposed rule through March 3, 2014. This rule proposes that controlling health plans (CHPs) must submit documentation that demonstrates compliance with the adopted standards and operating rules for three electronic transactions: Eligibility for a health plan Health care claim status Health care electronic funds transfers (EFT) and remittance advice The rule proposes that controlling health plans be required to submit documentation on or before December 31, 2015.  This proposed rule would also establish penalty fees for a CHP that fails to comply with the certification of compliance requirements. Subscriber Services: Manage Preferences | Unsubscribe

Centers for Medicare & Medicaid Services (CMS) has sent this update. To contact Centers for Medicare & Medicaid Services (CMS) go to our contact us page.