SDOs & Operating Rules Updates

Senators Request Information from CMS on Medicare Advantage Provider Directory Issues. Senators Jeff Merkley (D-OR), Ranking Member of the Senate Budget Committee, and Ron Wyden (D-OR), Ranking Member of the Senate Finance Committee, sent a letter to Centers for Medicare & Medicaid Services (CMS) Administrator Mehmet Oz, MD, requesting responses to potential issues with the…

QHIN Technical Framework V2.1 Posted for Review, Responses Due November 7. The Qualified Health Information Network® (QHIN™) Technical Framework (QTF) v2.1 is available for review on the TEFCA Topics in Change Management webpage. Comments on the draft QTF are being accepted until November 7. The Trusted Exchange Framework and Common Agreement™ (TEFCA™) Topics in Change…

CMS Issues Update on Holding of Claims for Affected Services. The Centers for Medicare & Medicaid Services (CMS) provided an update on the processing of claims and payments for services affected by the expired Medicare legislative provisions as of October 1. CMS has instructed Medicare Administrative Contractors to hold these claims but will continue to…

CMS Contracts Signal Commitment to Development of National Provider Directory. On September 30, the Centers for Medicare & Medicaid Services (CMS) awarded four contracts of $1 each to Availity, LLC, Council for Affordable Quality Healthcare, Inc, Gainwell Technologies, LLC, and Palantir Technologies, Inc. The stated purpose of the contracts is to procure information technology services…

OSTP and FDA Request Public Input on AI Use. The White House’s Office of Science and Technology Policy (OSTP) published a Request for Information (RFI) titled “Regulatory Reform on Artificial Intelligence” seeking input on identifying federal legislation, regulations, guidance, or other requirements that impede the development, deployment, and adoption of artificial intelligence (AI) technologies. The…

OCR Settles HIPAA Investigation of PHI Disclosure by Delaware Provider. The Department of Health and Human Services (HHS) Office of Civil Rights (OCR) announced a settlement with a Delaware health care provider for a potential violation of the Health Insurance Portability and Accountability Act (HIPAA) Privacy and Breach Notification Rules. The settlement resolves an investigation…

Hear from WEDI Chair-Elect, Denny Brennan, on why interoperability matters in the health care industry.

WEDI is conducting this follow up survey on the Centers for Medicare & Medicaid Services (CMS) Interoperability and Prior Authorization Final Rule (CMS-0057-F), and we need your help! This short survey will gauge how the industry is implementing this regulation. Don’t miss this important opportunity to share your perspectives on this significant industry mandate. WEDI’s second survey on…

WEDI Sends NSA Letter to Ways and Means Outlining Challenges with AEOBs. WEDI sent to the House Committee on Ways and Means its letter on the No Surprises Act (NSA) that it sent on September 8 to the Secretaries of the Departments of Health and Human Services (HHS), Labor, and Treasury and Director of the…