Spotlight

CMS Releases the Barriers to Oral Health Care Illustration

In the spring of 2022, CMS conducted the Oral Health Human-Centered Design Customer Engagement to understand barriers to oral health care access for Medicaid or dual (Medicare-Medicaid) eligible children and adults. CMS engaged directly with a broad range of external customers, including people with Medicaid, oral health providers, state representatives, and advocates, through interviews and onsite visits to capture their lived experience.

As a product of our research, we co-created the “Barriers to Oral Health” illustration with our external customers to represent their perspective and highlight the most prominent obstacles individuals’ face as they seek to access or provide oral health care.

The Oral Health Customer Engagement supports CMS’ Oral Health Cross-Cutting initiative (PDF), a priority for CMS.

View the Barriers to Oral Health Care Illustration (PDF).

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Thank You for Attending the 2023 CMS Conference on Optimizing Healthcare Delivery to Improve Patient Lives!

Thankyou to everyone who attended the 2023 CMS Conference on Optimizing Healthcare Delivery to Improve Patient Lives, held on November 15, 2023.

We appreciate your time and participation!

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2022 Compliance Review Findings Report Now Available

The Centers for Medicare & Medicaid Services’ (CMS) National Standards Group (NSG), on behalf of the U.S. Department of Health & Human Services (HHS), has released the 2022 Compliance Review Findings Report (PDF), identifying common standard and operating rule violations found during compliance reviews. This report expands on previously published reports, adding insights based on violation findings discovered in an additional 24 compliance reviews completed between April 2022 and March 2023.

CMS is sharing the updated findings to inform and educate the health care industry, encourage compliance, and assist covered entities with preparing for compliance reviews.

The Compliance Review Program aims to promote compliance with HIPAA Administrative Simplification rules for electronic health care transactions. Since the program launched in April 2019, NSG has initiated 63 compliance reviews with 53 health plans, four clearinghouses, and six providers.

Find out more about the Compliance Review Program with the Compliance Review Program Information Bulletin, (PDF) Compliance Review Infographic, (PDF) or on the Administrative Simplification website.

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New ASETT One Pager and Infographic Available

The Centers for Medicare & Medicaid Services’ (CMS) National Standards Group (NSG), on behalf of the U.S. Department of Health & Human Services (HHS), has released two new resources explaining how to use the Administrative Simplification Enforcement and Testing Tool (ASETT). Through ASETT—a free, online tool—individuals and organizations can test electronic health care transactions and file a complaint against a Health Insurance Portability and Accountability Act of 1996 (HIPAA) covered entity for noncompliance with Administrative Simplification requirements.

• How to Test Electronic Health Care Transactions for HIPAA Compliance (PDF) (PDF): Download this infographic to learn about testing your own electronic health care transactions and your trading partners’ transactions for compliance with Administrative Simplification requirements.
• Filing a Complaint with the Administrative Simplification Enforcement and Testing Tool (PDF) (PDF): Download this one pager to learn about filing a complaint against a HIPAA covered entity, directly or through a business associate acting on its behalf, that is potentially noncompliant with Administrative Simplification requirements.

Additional information on ASETT is also available in the following resources:

• How to File a Complaint Infographic (PDF) (PDF)
• ASETT Complaint Progress Infographic (PDF) (PDF)
• ASETT Quick Start Guide (PDF) (PDF)
• ASETT User Manual (PDF) (PDF)
• ASETT Frequently Asked Questions (PDF) (PDF)

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