Certification of Compliance – Centers for Medicare & Medicaid Services


On October 4, 2017, HHS published a withdrawal notice in the Federal Register for the proposed rule titled “Administrative Simplification: Certification of Compliance for Health Plans.” Please note that health plans still must comply with HIPAA-mandated standards and operating rules for electronic transactions. Also, HHS retains the authority to review health plans for compliance. But withdrawal of the proposed rule means that health plans will not have to certify their compliance as outlined in the proposed rule.

On January 2, 2014, CMS published a proposed rule that would require a controlling health plan (CHP) to submit information and documentation demonstrating that it is compliant with certain standards and operating rules adopted by the Secretary of Health and Human Services under the Health Insurance Portability and Accountability Act (HIPAA). The rule would also establish penalty fees for a CHP that fails to comply with the certification of compliance requirements. 

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via Certification of Compliance – Centers for Medicare & Medicaid Services


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