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Inside the Health Plan Compliance Certification Proposed Rule

Margaret Dick Tocknell, for HealthLeaders Media, January 8, 2014

According to the proposed rule, the submission requirements "are a snap shot" of a health plan's compliance with the standards and operating rules. "Such information and documentation does not reflect continuing compliance, nor do we do intend the information or documentation to be updated or resubmitted on a regular basis."

4. How must the documentation be submitted?
This is tricky. The proposed rule doesn't identify a specific submission format. The number of health plan covered lives (important only if a penalty is imposed) will probably be submitted via an online form. An electronic version or copy of the Phase III CORE Seal or the HIPAA Credential may be required to be submitted online, or HHS may ask for a tracking number that links to CAQH CORE records.

Remember, all of this is only a proposal for now. HHS really does want to know what you think, so submit your comments by March 4.


Margaret Dick Tocknell is a reporter/editor with HealthLeaders Media.
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