Compliance Review Program Launch

The Centers for Medicare & Medicaid Services (CMS) Division of National Standards, on behalf of the Department of Health and Human Services (HHS), is launching the Compliance Review Program to ensure compliance among covered entities with HIPAA Administrative Simplification rules for electronic health care transactions.

In April 2019, HHS will randomly select 9 HIPAA-covered entities—a mix of health plans and clearinghouses—for Compliance Reviews. Any health plan or clearinghouse—not just those who work with Medicare or Medicaid—may be selected. In 2018, HHS piloted the program with health plan and clearinghouse volunteers to streamline the process. In 2019, providers will be able to participate in a separate pilot program on a voluntary basis.

Moving forward, the Compliance Review Program will conduct periodic reviews with randomly selected entities to assess compliance.

Read the full Information Bulletin on the Go-to-Info page for more information, and watch for more Email Update messages with details about the program.

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Check out our video short, Reaching Compliance with ASETT.

Visit our website at go.cms.gov/AdminSimp.