Final Agenda


Subcommittee on Standards

Hearing on HIPAA and ACA Administrative Simplification
--Operating Rules, ICD-10, Health Plan ID, Pharmacy Prior Authorization--

Hubert H. Humphrey Building
Department of Health & Human Services
200 Independence Ave, SW, Room 705-A
Washington, DC 20201

Wednesday, February 19, 2014


Printable Agenda, Purpose & Background Questions

Meeting Summary


Hearing Purposes, Objectives

The purpose of this hearing is to review and discuss the current status of selected administrative simplification topics that are a priority for NCVHS in 2014.

The objectives of this hearing are as follows:

9:00 - 9:15 am

Welcome and Introductions

Standards Subcommittee Co-Chairs
Walter Suarez and Ob Soonthornsima

9:15 - 10:45 am

PANEL 1 - Review of Status Operating Rules
EFT/ERA Implementation; ORs for Remaining HIPAA Transactions

  • Operating Rules Authoring Entity
  • EFT Standards Authoring Entity
  • Other Payment Methods
  • Provider Perspective
  • Payer Perspectives
  • Banking Perspective

Gwen Lohse, CAQH
Janet Estep, NACHA
Heather McComas, AMA
Rob Tennant, MGMA
Janet Jackson, BCBSNC
Stuart Hanson, Citibank

10:45 - 11:00 am BREAK  

11:00 - 12:30 pm

PANEL 2 - ICD-10: Achieving a Successful Transition

  • CMS OESS Update
  • Medicare FFS
  • Medicaid
  • WEDI
  • Health Plans
  • Providers

  • Clearinghouses, Vendors

Matthew Albright, CMS, OESS
John Evangelist, CMS
Godwin Odia, CMS (via phone)
Jim Daley, WEDI
Sid Hebert, Humana
Rob Tennant, MGMA
Nancy Spector, AMA
George Arges, AHA
Meryl Bloomrosen, AHIMA
Jill Venskytis, PAHCOM
Debbie Meisner, Emdeon
Tim McMullen, Coop. Exchnage

12:30 - 1:15 pm LUNCH  

1:15 - 2:15 pm

PANEL 3 - ICD-10 Implementation Beyond Covered Entities

  • WEDI P&C eBilling Workgroup
  • Property/Property/Casualty Representative
  • Third Party Administrators

Sherry Wilson, Jopari Solutions
Tina Greene, Mitchell Intl.

Don St Jacques, Jopari Solutions
Robert Holden, AAPAN

2:15 - 3:15 pm

PANEL 4 - Pharmacy Prior Authorization

  • DSMO Recommendations
  • Industry Work Perspective
  • NCPDP Persepctive
  • Provider/Prescriber Perspective
  • CMS Perspective

Margaret Weiker, DSMO (via phone)
Tony Schueth, POCP
Lynne Gilbertson, NCPDP

Heather McComas, AMA
Andrew Morgan, OESS
3:15 - 3:30 pm BREAK  

3:30 - 4:45 pm

PANEL 5 - Health Plan ID Planning and Implementation Issues

  • HPID Introduction

  • WEDI Recommendations
  • Health Plan Perspective
  • Provider Perspectives
  • SDO Perspectives


Matthew Albright, OESS
Chevell Thomas, OESS

Laurie Darst
Gail Kocher, BCBSA
Rob Tennant, MGMA
Margaret Weiker, ASC X12 (via phone)
Laurie Burckhardt, ASC X12 (via phone)

Lynne Gilbertson, NCPDP


4:45 - 5:00 pm Public Comments  
5:00 pm Adjourn  


Panel 1 – Operating Rules

Panel 2 –ICD-10: Achieving a Successful Transition

Panel 3 – ICD-10 Implementation Beyond Covered Entities

Panel 4 – Pharmacy Prior Authorization

Panel 5 – Health Plan ID Planning and Implementation Issues

Should you require reasonable accommodation, please contact the CDC Office of Equal Employment Opportunity on (301) 458-4EEO (4336) as soon as possible.

Times, topics, and speakers are subject to change. For final agenda, please call 301-458-4200 at NCHS or visit the NCVHS Home Page at

February 27, 2014