Compliance Review Program Resources

The CMS Division of National Standards, on behalf of the Department of Health and Human Services, 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.

Watch the new CMS video about the Compliance Review Program to learn about why compliance reviews are important for the health care industry and how they will be conducted.

To prepare for the Compliance Review Program, the following resources are available:

• Compliance Review Program Information Bulletin
• What to Expect Q&A
• Prep Steps
• Optimization Pilot Information Bulletin