Engagement with standards and operating rules

NCVHS

The National Committee on Vital and Health Statistics (NCVHS) is the public advisory body to the Secretary of Health and Human Services (HHS), and fulfills a vital role for bringing stakeholders together to discuss issues which impact practice and business. This public process assures transparency and engagement. NCVHS's Subcommittee on Standards monitors and makes recommendations to the Secretary on health data standards, and has been active for more than 10 years advising on issues pertaining to HIPAA. With the passage of the Affordable Care Act, new standards and operating rules will come before this committee, and new recommendations will be forthcoming.

As the public forum on health information technology standards, the Subcommittee provides a vehicle for public engagement with: consumer groups, providers, health plans, public health agencies, Standards Development Organizations, operating rule entities, the research community, and Federal, state and local governments.

A complete schedule of meetings; copies of reports and recommendations, transcripts, and downloadable recordings of audio webcasts are available at the NCVHS website.

NCVHS recommends CAQH CORE as authoring entity for remaining operating rules

The Affordable Care Act of 2010 (ACA) charges NCVHS with informing HHS on the entity/entities that meet the requirements to serve as authoring organizations for operating rules to support the HIPAA standard transactions.  The committee is also to select and inform HHS on which proposed operating rules should be adopted.     
In March 2012, NCVHS advised the Secretary to designate CAQH CORE as the operating rule authoring entity for the remaining health care transactions adopted under HIPAA.  In September 2012, the Secretary accepted the NCVHS recommendation.  To see a copy of the letter, visit the NCVHS website.

The remaining transactions are: health claims attachments, health care claims, enrollment and disenrollment in a health plan, premium payment, and referrals and authorizations. To learn how to participate in one of the work groups for the remaining transactions, visit the CAQH CORE website.

Industry Participation

The standards and operating rules can only be developed effectively if a diverse body representing all stakeholders needs and interests is engaged.  CMS strongly encourages participation in workgroups and committees, and encourages appropriate membership to ensure voting rights.  Health plans, provider groups, clearinghouses, vendors, consultants, associations, state Medicaid agencies community health centers, etc. must be equally and equitably represented as standards are updated, operating rules written and change requests considered.  Visit the X12, HL7, NCPDP, and CAQH CORE websites to find out which groups are active and how to join and participate.  If participation is a hardship, please advise your professional association and request their support in representing you.