In Productivity & Management

The U.S. Department of Health and Human Services (HHS), Division of National Standards (DNS) within the Centers for Medicare & Medicaid Services (CMS), has recognized Change Healthcare for successfully completing the HHS Optimization Program Pilot of Administrative Simplification transaction standards, code sets, unique identifiers, and operating rules.

This recognition means Change Healthcare is one of the first organizations certified by the DNS, demonstrating that the company’s Medical, Hospital, and Dental Exchange batch and real-time services and solutions have been reviewed for compliance with HIPAA Administrative Simplification regulations and ACA Operating Rule provisions.

The assessment process is a cornerstone for the rollout of the Administrative Simplification Optimization Program, as universal compliance with adopted standards is projected to save the healthcare industry more than $9 billion per year.

“Change Healthcare’s services and solutions are well aligned with HIPAA’s Administrative Simplification provisions’ purpose of improving the efficiency and effectiveness of the nation’s health care system and, ultimately, reducing administrative costs,” said Mike Peresie, General Manager, Medical Network, Change Healthcare.

Added Sajid Khan, General Manager of Dental Network Services at Change Healthcare: “As one of the nation’s largest healthcare networks, our customers can (and do) expect us to be on the leading edge of compliance initiatives. To be among the first to achieve HHS certification demonstrates Change Healthcare’s continued commitment to compliance and our customers.”

Launched earlier this year, the HHS Optimization Program Pilot solicited clearinghouse and health plan volunteers to participate in an opportunity to submit electronic transaction files for review and testing by HHS, as well as attest to compliance with operating rules.

Those selected received a compliance review package outlining details about the process and, upon completion, HHS provided participants with a report that flagged any issues that needed to be addressed for full compliance. Organizations that achieved successful reviews received a dated certificate of completion from HHS.

HHS indicates the pilot will inform the rollout of the Administrative Simplification Optimization Program, where HHS will begin conducting proactive compliance reviews of randomly selected health plans and clearinghouses.

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