Administrative Simplification

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menu-item--collapsed"> <a href="/medicare/medicaid-coordination/center-program-integrity/resources" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/674936">Resources</a> </li> <li class="menu-item menu-item--l3"> <a href="/medicare/medicaid-coordination/about/qualified-medicare-beneficiary-program" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/184631">Qualified Medicare beneficiary program</a> </li> <li class="menu-item menu-item--l3 menu-item--collapsed"> <a href="/medicare/medicaid-coordination/center-program-integrity/spotlight" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/674941">Spotlight</a> </li> <li class="menu-item menu-item--l3"> <a href="/medicare/medicaid-coordination/center-program-integrity/events" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/674946">Events</a> </li> <li class="menu-item menu-item--l3 menu-item--collapsed"> <a href="/medicaid-chip/medicare-coordination/financial-alignment" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/178246">Financial alignment initiative</a> </li> <li class="menu-item menu-item--l3 menu-item--collapsed"> <a href="/medicaid-chip/medicare-coordination/avoidable-hospitalizations" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/181236">Initiative to reduce avoidable hospitalizations </a> </li> <li class="menu-item menu-item--l3 menu-item--collapsed"> <a href="/medicare/medicaid-coordination/center-program-integrity/reports-guidance" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/674951">Reports & Guidance</a> </li> <li class="menu-item menu-item--l3"> <a href="/medicare/medicaid-coordination/pace" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/175651">Program of All-Inclusive Care for the Elderly (PACE)</a> </li> <li class="menu-item 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<a href="/medicare/appeals-grievances/managed-care" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/169961">Managed Care appeals & grievances</a> </li> <li class="menu-item menu-item--l3 menu-item--collapsed"> <a href="/medicare/appeals-grievances/prescription-drug" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/171101">Medicare Prescription drug appeals & grievances</a> </li> <li class="menu-item menu-item--l3"> <a href="/medicare/appeals-grievances/ombudsman-center" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/193386">Ombudsman Center</a> </li> <li class="menu-item menu-item--l3"> <a href="/medicare/appeals-grievances/appeals-decision-search-part-c-d" class="menu-item-element" aria-current="false" data-drupal-link-system-path="qic-decision-search">Appeals Decision Search (Part C & Part D)</a> </li> </ul> </div> </div> </li> <li class="menu-item menu-item--l2 menu-item--expanded"> <span class="menu-item-element" aria-current="false">Quality</span> <div class="subnav-wrapper--2 ds-u-display--none"> <div class="subnav-header"> <span class="back-to-l2 ds-u-lg-display--none">Back to <span class="l2-placeholder"></span> menu</span> <h3 class="subnav-title-h3" style="position:relative;text-align:left;">section title h3</h3> </div> <div class="menu-wrapper"> <ul class="menu"> <li class="menu-item menu-item--l3 menu-item--collapsed"> <a href="/medicare/quality/value-based-programs" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/188566">Value-based programs</a> </li> <li class="menu-item menu-item--l3"> <a href="/medicare/quality/initiatives/hospital-quality-initiative/person-family-engagement" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/182996">Person & Family Engagement</a> </li> <li class="menu-item menu-item--l3 menu-item--collapsed"> <a href="/medicare/quality/quality-improvement-organizations" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/169871">Quality improvement organizations</a> </li> <li class="menu-item menu-item--l3 menu-item--collapsed"> <a href="/medicare/quality/nursing-home-improvement" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/171236">Nursing home quality improvement</a> </li> <li class="menu-item menu-item--l3 menu-item--collapsed"> <a href="/medicare/quality/inpatient-rehabilitation-facility" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/175616">Inpatient Rehabilitation Facility (IRF) Quality Reporting Program (QRP)</a> </li> <li class="menu-item menu-item--l3 menu-item--collapsed"> <a href="/medicare/quality/home-health" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/170541">Home Health Quality Reporting Program</a> </li> <li class="menu-item menu-item--l3 menu-item--collapsed"> <a href="/medicare/quality/end-stage-renal-disease-esrd-quality-incentive-program" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/176126">ESRD Quality Incentive Program</a> </li> <li class="menu-item menu-item--l3 menu-item--collapsed"> <a href="/medicare/quality/meaningful-measures-initiative/cms-quality-strategy" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/178276">CMS National Quality Strategy</a> </li> <li class="menu-item menu-item--l3 menu-item--collapsed"> <a href="/medicare/quality/hospice" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/175556">Hospice Quality Reporting Program</a> </li> <li class="menu-item menu-item--l3 menu-item--collapsed"> <a href="/medicare/quality/long-term-care-hospital" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/175511">Long-Term Care Hospital (LTCH) Quality Reporting Program (QRP)</a> </li> <li class="menu-item menu-item--l3 menu-item--collapsed"> <a href="/medicare/quality/appropriate-use-criteria-program" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/180421">Appropriate Use Criteria Program</a> </li> <li class="menu-item menu-item--l3 menu-item--collapsed"> <a href="/medicare/quality/measures" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/172001">Quality measures</a> </li> <li class="menu-item menu-item--l3 menu-item--collapsed"> <a href="/medicare/quality/clinical-laboratory-improvement-amendments" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/172651">Clinical Laboratory Improvement Amendments (CLIA)</a> </li> <li class="menu-item menu-item--l3 menu-item--collapsed"> <a href="/medicare/advantage-quality-improvement-program" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/177561">Medicare Advantage quality improvement program</a> </li> <li class="menu-item menu-item--l3 menu-item--collapsed"> <a href="/medicare/quality/physician-compare-initiative" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/175221">Physician compare initiative</a> </li> <li class="menu-item menu-item--l3 menu-item--collapsed"> <a href="/medicare/quality/initiatives" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/169636">Quality initiatives</a> </li> <li class="menu-item menu-item--l3"> <a href="/medicare/health-drug-plans/part-c-d-performance-data" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/171491">Part C and D Performance Data</a> </li> <li class="menu-item menu-item--l3 menu-item--collapsed"> <a href="/medicare/quality/snf-quality-reporting-program" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/180061"> Skilled Nursing Facility (SNF) Quality Reporting Program (QRP)</a> </li> </ul> </div> </div> </li> <li class="menu-item menu-item--l2 menu-item--expanded"> <span class="menu-item-element" aria-current="false">Health & safety standards</span> <div class="subnav-wrapper--2 ds-u-display--none"> <div class="subnav-header"> <span class="back-to-l2 ds-u-lg-display--none">Back to <span class="l2-placeholder"></span> menu</span> <h3 class="subnav-title-h3" style="position:relative;text-align:left;">section title h3</h3> </div> <div class="menu-wrapper"> <ul class="menu"> <li class="menu-item menu-item--l3 menu-item--collapsed"> <a href="/medicare/health-safety-standards/quality-safety-oversight-general-information" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/169631">Quality, safety & oversight - General information</a> </li> <li class="menu-item menu-item--l3"> <a href="/medicare/health-safety-standards/accreditation-programs" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/171481">Accreditation programs</a> </li> <li class="menu-item menu-item--l3"> <a href="/medicare/health-safety-standards/civil-monetary-penalties" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/182431">Civil monetary penalties</a> </li> <li class="menu-item menu-item--l3 menu-item--collapsed"> <a href="/medicare/health-safety-standards/quality-safety-oversight-emergency-preparedness" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/172346">Quality, safety & oversight - Emergency preparedness</a> </li> <li class="menu-item menu-item--l3"> <a href="/medicare/health-safety-standards/state-survey-agencies" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/171271">State survey agencies</a> </li> <li class="menu-item menu-item--l3 menu-item--collapsed"> <a href="/medicare/health-safety-standards/certification-compliance" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/171241">Certification & compliance</a> </li> <li class="menu-item menu-item--l3 menu-item--collapsed"> <a href="/medicare/health-safety-standards/enforcement" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/169811">Enforcement</a> </li> <li class="menu-item menu-item--l3 menu-item--collapsed"> <a href="/medicare/health-safety-standards/guidance-for-laws-regulations" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/170071">Quality, safety & oversight - Guidance for laws & regulations</a> </li> <li class="menu-item menu-item--l3 menu-item--collapsed"> <a href="/medicare/health-safety-standards/promising-practices-project" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/172211">Promising practices project</a> </li> <li class="menu-item menu-item--l3"> <a href="/medicare/health-safety-standards/education-division" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/173371">Quality, safety & oversight - Education division (QSED)</a> </li> <li class="menu-item menu-item--l3 menu-item--collapsed"> <a href="/medicare/health-safety-standards/conditions-coverage-participation" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/172616">Conditions for coverage & participation</a> </li> </ul> </div> </div> </li> <li class="menu-item menu-item--l2 menu-item--expanded"> <span class="menu-item-element" aria-current="false">Employers & plan sponsors</span> <div class="subnav-wrapper--2 ds-u-display--none"> <div class="subnav-header"> <span class="back-to-l2 ds-u-lg-display--none">Back to <span class="l2-placeholder"></span> menu</span> <h3 class="subnav-title-h3" style="position:relative;text-align:left;">section title h3</h3> </div> <div class="menu-wrapper"> <ul class="menu"> <li class="menu-item menu-item--l3 menu-item--collapsed"> <a href="/medicare/employers-plan-sponsors/creditable-coverage" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/171701">Creditable coverage</a> </li> </ul> </div> </div> </li> <li class="menu-item menu-item--l2"> <span class="menu-item-element" aria-current="false">IC-Placeholder-1</span> </li> <li class="menu-item menu-item--l2 menu-item--expanded"> <span class="menu-item-element" aria-current="false">Audits & Compliance</span> <div class="subnav-wrapper--2 ds-u-display--none"> <div class="subnav-header"> <span class="back-to-l2 ds-u-lg-display--none">Back to <span class="l2-placeholder"></span> menu</span> <h3 class="subnav-title-h3" style="position:relative;text-align:left;">section title h3</h3> </div> <div class="menu-wrapper"> <ul class="menu"> <li class="menu-item menu-item--l3 menu-item--collapsed"> <a href="/medicare/audits-compliance/part-a-cost-report" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/185256">Part A cost report audit</a> </li> <li class="menu-item menu-item--l3 menu-item--collapsed"> <a href="/medicare/audits-compliance/part-c-d" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/175921">Part C/Part D compliance & audits</a> </li> </ul> </div> </div> </li> <li class="menu-item menu-item--l2 menu-item--expanded"> <span class="menu-item-element" aria-current="false">Forms & notices</span> <div class="subnav-wrapper--2 ds-u-display--none"> <div class="subnav-header"> <span class="back-to-l2 ds-u-lg-display--none">Back to <span class="l2-placeholder"></span> menu</span> <h3 class="subnav-title-h3" style="position:relative;text-align:left;">section title h3</h3> </div> <div class="menu-wrapper"> <ul class="menu"> <li class="menu-item menu-item--l3"> <a href="/medicare/forms-notices/cms-forms" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/170166">CMS forms</a> </li> <li class="menu-item menu-item--l3"> <a href="/medicare/forms-notices/cms-forms-list" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/174306">CMS forms list</a> </li> <li class="menu-item menu-item--l3 menu-item--collapsed"> <a href="/medicare/forms-notices/beneficiary-notices-initiative" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/170686">Beneficiary Notices Initiative (BNI)</a> </li> </ul> </div> </div> </li> <li class="menu-item menu-item--l2 menu-item--expanded"> <span class="menu-item-element" aria-current="false">Health & drug plans</span> <div class="subnav-wrapper--2 ds-u-display--none"> <div class="subnav-header"> <span class="back-to-l2 ds-u-lg-display--none">Back to <span class="l2-placeholder"></span> menu</span> <h3 class="subnav-title-h3" style="position:relative;text-align:left;">section title h3</h3> </div> <div class="menu-wrapper"> <ul class="menu"> <li class="menu-item menu-item--l3 menu-item--collapsed"> <a href="/medicare/health-drug-plans/plan-payment" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/171981">Plan payment</a> </li> <li class="menu-item menu-item--l3"> <a href="/medicare/health-drug-plans/plan-payment-data" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/175081">Plan payment data</a> </li> <li class="menu-item menu-item--l3"> <a href="/medicare/health-drug-plans/medical-loss-ratio" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/180161">Medical loss ratio</a> </li> <li class="menu-item menu-item--l3"> <a href="/medicare/health-drug-plans/coverage-gap-discount-program" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/175906">Coverage Gap Discount Program</a> </li> <li class="menu-item menu-item--l3 menu-item--collapsed"> <a href="/medicare/health-drug-plans/managed-care-marketing" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/170611">Managed care marketing</a> </li> <li class="menu-item menu-item--l3"> <a href="/medicare/health-drug-plans/medicare-advantage-application" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/170651">Medicare Advantage application</a> </li> <li class="menu-item menu-item--l3 menu-item--collapsed"> <a href="/medicare/health-drug-plans/medigap" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/170466">Medigap (Medicare supplement health insurance)</a> </li> <li class="menu-item menu-item--l3"> <a href="/medicare/health-drug-plans/medical-savings-account" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/172066">Medical Savings Account (MSA)</a> </li> <li class="menu-item menu-item--l3 menu-item--collapsed"> <a href="/medicare/health-drug-plans/private-fee-for-service-plans" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/170301">Private Fee-for-Service Plans</a> </li> <li class="menu-item menu-item--l3"> <a href="/medicare/enrollment-renewal/health-plans/prepayment" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/170521">Health Care Prepayment Plans (HCPPs)</a> </li> <li class="menu-item menu-item--l3"> <a href="/medicare/enrollment-renewal/health-plans/cost" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/170656">Cost plans</a> </li> <li class="menu-item menu-item--l3 menu-item--collapsed"> <a href="/medicare/enrollment-renewal/special-needs-plans" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/171676">Special needs plans</a> </li> <li class="menu-item menu-item--l3"> <a href="/medicare/health-drug-plans/network-adequacy" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/171301">Network adequacy</a> </li> </ul> </div> </div> </li> <li class="menu-item menu-item--l2 menu-item--expanded"> <span class="menu-item-element" aria-current="false">Coordination of benefits & recovery</span> <div class="subnav-wrapper--2 ds-u-display--none"> <div class="subnav-header"> <span class="back-to-l2 ds-u-lg-display--none">Back to <span class="l2-placeholder"></span> menu</span> <h3 class="subnav-title-h3" style="position:relative;text-align:left;">section title h3</h3> </div> <div class="menu-wrapper"> <ul class="menu"> <li class="menu-item menu-item--l3 menu-item--collapsed"> <a href="/medicare/coordination-benefits-recovery/overview" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/177001">Overview</a> </li> <li class="menu-item menu-item--l3 menu-item--collapsed"> <a href="/medicare/coordination-benefits-recovery/mandatory-insurer-reporting-group-health-plans" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/176856">Mandatory Insurer Reporting for Group Health Plans (GHP)</a> </li> <li class="menu-item menu-item--l3 menu-item--collapsed"> <a href="/medicare/coordination-benefits-recovery/mandatory-insurer-reporting" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/176951">Mandatory insurer reporting (NGHP)</a> </li> <li class="menu-item menu-item--l3 menu-item--collapsed"> <a href="/medicare/coordination-benefits-recovery/workers-comp-set-aside-arrangements" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/176641">Workers' comp Medicare set aside arrangements</a> </li> <li class="menu-item menu-item--l3 menu-item--collapsed"> <a href="/medicare/coordination-benefits-recovery/attorney-services" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/177026">Attorney services</a> </li> <li class="menu-item menu-item--l3 menu-item--collapsed"> <a href="/medicare/coordination-benefits-recovery/beneficiary-services" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/177036">Beneficiary services</a> </li> <li class="menu-item menu-item--l3 menu-item--collapsed"> <a href="/medicare/coordination-benefits-recovery/coba-trading-partners" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/176761">COBA Trading Partners</a> </li> <li class="menu-item menu-item--l3 menu-item--collapsed"> <a href="/medicare/coordination-benefits-recovery/employer-services" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/170361">Employer services</a> </li> <li class="menu-item menu-item--l3 menu-item--collapsed"> <a href="/medicare/coordination-benefits-recovery/insurer-services" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/170846">Insurer services</a> </li> <li class="menu-item menu-item--l3 menu-item--collapsed"> <a href="/medicare/coordination-benefits-recovery/prescription-drug-assistance-programs" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/176791">Prescription drug assistance programs</a> </li> <li class="menu-item menu-item--l3 menu-item--collapsed"> <a href="/medicare/coordination-benefits-recovery/provider-services" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/170406">Provider services</a> </li> </ul> </div> </div> </li> <li class="menu-item menu-item--l2 menu-item--expanded"> <span class="menu-item-element" aria-current="false">Settlements</span> <div class="subnav-wrapper--2 ds-u-display--none"> <div class="subnav-header"> <span class="back-to-l2 ds-u-lg-display--none">Back to <span class="l2-placeholder"></span> menu</span> <h3 class="subnav-title-h3" style="position:relative;text-align:left;">section title h3</h3> </div> <div class="menu-wrapper"> <ul class="menu"> <li class="menu-item menu-item--l3"> <a href="/medicare/settlements/jimmo" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/193381">Jimmo Settlement</a> </li> <li class="menu-item menu-item--l3"> <a href="/medicare/settlements/ryan" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/193486">Ryan Settlement</a> </li> </ul> </div> </div> </li> </ul> </div> </li> <li class="menu-item menu-item--l1 menu-item--expanded"> <span class="menu-item-element" aria-current="false">Medicaid/CHIP</span> <div class="subnav-wrapper--1 ds-u-display--none"> <div class="subnav-header"> <span class="back-to-main ds-u-lg-display--none">Back to main menu</span> <h2 class="subnav-title-h2" style="position:relative;text-align:left;width:auto;height:auto;">section title h2</h2> </div> <ul class="menu"> <li class="menu-item menu-item--l2 menu-item--expanded"> <span class="menu-item-element" aria-current="false">What is Medicaid?</span> <div class="subnav-wrapper--2 ds-u-display--none"> <div class="subnav-header"> <span class="back-to-l2 ds-u-lg-display--none">Back to <span class="l2-placeholder"></span> menu</span> <h3 class="subnav-title-h3" style="position:relative;text-align:left;">section title h3</h3> </div> <div class="menu-wrapper"> <ul class="menu"> <li class="menu-item menu-item--l3"> <a href="https://www.medicaid.gov" class="menu-item-element" aria-current="false">Visit Medicaid.gov</a> </li> <li class="menu-item menu-item--l3"> <a href="https://www.medicaid.gov/about-us/beneficiary-resources/index.html#statemenu" class="menu-item-element" aria-current="false">View Medicaid maps</a> </li> <li class="menu-item menu-item--l3"> <a href="http://www.medicaid.gov/chip/index.html" class="menu-item-element" aria-current="false">Visit CHIP.gov</a> </li> </ul> </div> </div> </li> <li class="menu-item menu-item--l2 menu-item--expanded"> <span class="menu-item-element" aria-current="false">Medicare-Medicaid Coordination</span> <div class="subnav-wrapper--2 ds-u-display--none"> <div class="subnav-header"> <span class="back-to-l2 ds-u-lg-display--none">Back to <span class="l2-placeholder"></span> menu</span> <h3 class="subnav-title-h3" style="position:relative;text-align:left;">section title h3</h3> </div> <div class="menu-wrapper"> <ul class="menu"> <li class="menu-item menu-item--l3"> <a href="/medicaid-chip/medicare-coordination/integrated-care-resources" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/174926">Integrated care resources</a> </li> <li class="menu-item menu-item--l3"> <a href="/medicaid-chip/medicare-coordination/avoidable-hospitalizations" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/181236">Initiative to reduce avoidable hospitalizations</a> </li> <li class="menu-item menu-item--l3 menu-item--collapsed"> <a href="/medicaid-chip/medicare-coordination/financial-alignment" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/178246">Financial alignment initiative</a> </li> <li class="menu-item menu-item--l3 menu-item--collapsed"> <a href="/medicaid-chip/medicare-coordination/integrity-institute" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/1315141">Medicaid Integrity Institute</a> </li> </ul> </div> </div> </li> <li class="menu-item menu-item--l2"> <span class="menu-item-element" aria-current="false">RG-Placeholder-1</span> </li> <li class="menu-item menu-item--l2"> <span class="menu-item-element" aria-current="false">IC-Placeholder-2</span> </li> </ul> </div> </li> <li class="menu-item menu-item--l1 menu-item--expanded"> <span class="menu-item-element" aria-current="false">Marketplace & Private Insurance</span> <div class="subnav-wrapper--1 ds-u-display--none"> <div class="subnav-header"> <span class="back-to-main ds-u-lg-display--none">Back to main menu</span> <h2 class="subnav-title-h2" style="position:relative;text-align:left;width:auto;height:auto;">section title h2</h2> </div> <ul class="menu"> <li class="menu-item menu-item--l2 menu-item--expanded"> <span class="menu-item-element" aria-current="false">About the Marketplace</span> <div class="subnav-wrapper--2 ds-u-display--none"> <div class="subnav-header"> <span class="back-to-l2 ds-u-lg-display--none">Back to <span class="l2-placeholder"></span> menu</span> <h3 class="subnav-title-h3" style="position:relative;text-align:left;">section title h3</h3> </div> <div class="menu-wrapper"> <ul class="menu"> <li class="menu-item menu-item--l3 menu-item--collapsed"> <a href="/marketplace/about/oversight" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/191061">Marketplace oversight</a> </li> <li class="menu-item menu-item--l3 menu-item--collapsed"> <a href="/marketplace/about/affordable-care-act" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/191416">Affordable Care Act</a> </li> <li class="menu-item menu-item--l3 menu-item--collapsed"> <a href="/marketplace/about/overview-exchanges" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/190921">Overview of the exchanges</a> </li> <li class="menu-item menu-item--l3"> <a href="/marketplace/about/exchange-coverage-maps" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/193086">Exchange coverage maps</a> </li> <li class="menu-item menu-item--l3"> <a href="/marketplace/about/medicare" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/179351">Medicare and the Marketplace</a> </li> </ul> </div> </div> </li> <li class="menu-item menu-item--l2 menu-item--expanded"> <span class="menu-item-element" aria-current="false">Private Health Insurance</span> <div class="subnav-wrapper--2 ds-u-display--none"> <div class="subnav-header"> <span class="back-to-l2 ds-u-lg-display--none">Back to <span class="l2-placeholder"></span> menu</span> <h3 class="subnav-title-h3" style="position:relative;text-align:left;">section title h3</h3> </div> <div class="menu-wrapper"> <ul class="menu"> <li class="menu-item menu-item--l3"> <a href="/marketplace/private-health-insurance/patient-bill-of-rights" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/192591">Patient’s Bill of Rights</a> </li> <li class="menu-item menu-item--l3"> <a href="/marketplace/private-health-insurance/medical-loss-ratio" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/190956">Medical loss ratio</a> </li> <li class="menu-item menu-item--l3"> <a href="/marketplace/private-health-insurance/annual-limits" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/191976">Annual limits</a> </li> <li class="menu-item menu-item--l3"> <a href="/marketplace/private-health-insurance/review-insurance-rates" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/192716">Review of insurance rates</a> </li> <li class="menu-item menu-item--l3"> <a href="/marketplace/private-health-insurance/market-rating-reforms" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/191816">Market rating</a> </li> <li class="menu-item menu-item--l3"> <a href="/marketplace/private-health-insurance/self-funded-non-federal-governmental-plans" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/191111">Self-funded, non-federal governmental plans</a> </li> <li class="menu-item menu-item--l3"> <a href="/marketplace/private-health-insurance/grandfathered-plans" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/191456">Grandfathered plans</a> </li> <li class="menu-item menu-item--l3"> <a href="/marketplace/private-health-insurance/health-reimbursement-arrangements" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/193216">Health Reimbursement Arrangements</a> </li> <li class="menu-item menu-item--l3"> <a href="/marketplace/private-health-insurance/coverage-young-adults" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/190931">Coverage for young adults</a> </li> <li class="menu-item menu-item--l3"> <a href="/marketplace/private-health-insurance/student-health-plans" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/190946">Student health plans</a> </li> <li class="menu-item menu-item--l3"> <a href="/marketplace/private-health-insurance/mental-health-parity-addiction-equity" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/192601">Mental health parity and addiction equity</a> </li> <li class="menu-item menu-item--l3"> <a href="/marketplace/private-health-insurance/prevention" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/191071">Prevention</a> </li> <li class="menu-item menu-item--l3"> <a href="/marketplace/private-health-insurance/consumer-protections-enforcement" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/192701">Consumer protections & enforcement</a> </li> <li class="menu-item menu-item--l3"> <a href="/marketplace/private-health-insurance/pre-existing-condition-plan" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/191056">Pre-existing condition insurance plan</a> </li> <li class="menu-item menu-item--l3"> <a href="https://www.healthcare.gov/glossary/qualifying-health-coverage" class="menu-item-element" aria-current="false">Qualifying Health Coverage (QHC)</a> </li> </ul> </div> </div> </li> <li class="menu-item menu-item--l2"> <span class="menu-item-element" aria-current="false">RG-Placeholder-2</span> </li> <li class="menu-item menu-item--l2 menu-item--expanded"> <span class="menu-item-element" aria-current="false">In-person assisters</span> <div class="subnav-wrapper--2 ds-u-display--none"> <div class="subnav-header"> <span class="back-to-l2 ds-u-lg-display--none">Back to <span class="l2-placeholder"></span> menu</span> <h3 class="subnav-title-h3" style="position:relative;text-align:left;">section title h3</h3> </div> <div class="menu-wrapper"> <ul class="menu"> <li class="menu-item menu-item--l3"> <a href="/marketplace/in-person-assisters/information-partners" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/2078851">Information for Partners</a> </li> <li class="menu-item menu-item--l3 menu-item--collapsed"> <a href="/marketplace/in-person-assisters/outreach-education" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/2073436">Assister outreach & education</a> </li> <li class="menu-item menu-item--l3 menu-item--collapsed"> <a href="/marketplace/in-person-assisters/applications-forms-notices" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/2073441">Applications, forms, & notices</a> </li> <li class="menu-item menu-item--l3 menu-item--collapsed"> <a href="/marketplace/in-person-assisters/programs-procedures" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/2073446">Assister programs & procedures</a> </li> <li class="menu-item menu-item--l3 menu-item--collapsed"> <a href="/marketplace/in-person-assisters/technical-resources" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/2073231">Assister technical resources</a> </li> <li class="menu-item menu-item--l3 menu-item--collapsed"> <a href="/marketplace/in-person-assisters/training-webinars" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/2073451">Assister training & webinars</a> </li> </ul> </div> </div> </li> <li class="menu-item menu-item--l2 menu-item--expanded"> <span class="menu-item-element" aria-current="false">Agents & Brokers</span> <div class="subnav-wrapper--2 ds-u-display--none"> <div class="subnav-header"> <span class="back-to-l2 ds-u-lg-display--none">Back to <span class="l2-placeholder"></span> menu</span> <h3 class="subnav-title-h3" style="position:relative;text-align:left;">section title h3</h3> </div> <div class="menu-wrapper"> <ul class="menu"> <li class="menu-item menu-item--l3"> <a href="/marketplace/agents-brokers/resources" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/192876">Resources for Agent & Brokers</a> </li> <li class="menu-item menu-item--l3"> <a href="/marketplace/agents-brokers/registration-training" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/1290426">Registration & training</a> </li> <li class="menu-item menu-item--l3"> <a href="/marketplace/agents-brokers/open-enrollment" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/193226">Open enrollment</a> </li> <li class="menu-item menu-item--l3"> <a href="/marketplace/agents-brokers/direct-enrollment-partners" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/1550226">Direct enrollment partners</a> </li> <li class="menu-item menu-item--l3"> <a href="/marketplace/agents-brokers/general-resources" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/185021">General resources</a> </li> <li class="menu-item menu-item--l3"> <a href="https://www.youtube.com/playlist?list=PLaV7m2-zFKpgUK9AqdbnOdW69-WwodvRj" class="menu-item-element" aria-current="false">Video Learning Center</a> </li> <li class="menu-item menu-item--l3"> <a href="https://www.agentbrokerfaq.cms.gov/s/" class="menu-item-element" aria-current="false">Agent & Broker FAQ</a> </li> <li class="menu-item menu-item--l3"> <a href="/files/document/agent/broker-help-desks.pdf" class="menu-item-element" aria-current="false" data-drupal-link-system-path="media/112386">Marketplace help desk & call centers</a> </li> <li class="menu-item menu-item--l3"> <a href="https://data.healthcare.gov/ffm_ab_registration_lists" class="menu-item-element" aria-current="false">Registration Completion List</a> </li> <li class="menu-item menu-item--l3"> <a href="https://data.healthcare.gov/ab-registration-tracker/" class="menu-item-element" aria-current="false">Marketplace Registration Tracker</a> </li> <li class="menu-item menu-item--l3"> <a href="https://data.healthcare.gov/ab-suspension-and-termination-list" class="menu-item-element" aria-current="false">AB Suspension & Termination List</a> </li> <li class="menu-item menu-item--l3"> <a href="https://localhelp.healthcare.gov/" class="menu-item-element" aria-current="false">Find local help</a> </li> <li class="menu-item menu-item--l3"> <a href="https://data.healthcare.gov/issuer-partner-lookup" class="menu-item-element" aria-current="false">Issuer and direct enrollment partner directory</a> </li> <li class="menu-item menu-item--l3"> <a href="/marketplace/agents-brokers/help-on-demand" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/193196">Help on demand</a> </li> <li class="menu-item menu-item--l3"> <a href="/marketplace/agents-brokers/shop-resources" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/193096">SHOP Resources</a> </li> </ul> </div> </div> </li> <li class="menu-item menu-item--l2 menu-item--expanded"> <span class="menu-item-element" aria-current="false">Health Plans & Issuers</span> <div class="subnav-wrapper--2 ds-u-display--none"> <div class="subnav-header"> <span class="back-to-l2 ds-u-lg-display--none">Back to <span class="l2-placeholder"></span> menu</span> <h3 class="subnav-title-h3" style="position:relative;text-align:left;">section title h3</h3> </div> <div class="menu-wrapper"> <ul class="menu"> <li class="menu-item menu-item--l3"> <a href="/marketplace/health-plans-issuers/qualified-health-plan-certification" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/191371">Qualified health plan certification </a> </li> <li class="menu-item menu-item--l3"> <a href="/marketplace/health-plans-issuers/summary-benefits-coverage" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/191461">Summary of benefits & coverage</a> </li> <li class="menu-item menu-item--l3 menu-item--collapsed"> <a href="/marketplace/health-plans-issuers/insurance-programs" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/192101">Insurance programs</a> </li> <li class="menu-item menu-item--l3 menu-item--collapsed"> <a href="/marketplace/health-plans-issuers/premium-stabilization-programs" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/191326">Premium stabilization programs</a> </li> <li class="menu-item menu-item--l3"> <a href="/marketplace/health-plans-issuers/insurance-market-reforms" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/191421">Health insurance market reforms</a> </li> <li class="menu-item menu-item--l3"> <a href="/marketplace/health-plans-issuers/minimum-essential-coverage" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/192891">Minimum essential coverage</a> </li> <li class="menu-item menu-item--l3"> <a href="/marketplace-private-insurance/health-plans-issuers/pbm-drug-pricing-review" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/2088761">Drug pricing & rebate review</a> </li> </ul> </div> </div> </li> <li class="menu-item menu-item--l2 menu-item--expanded"> <span class="menu-item-element" aria-current="false">Employers & sponsors</span> <div class="subnav-wrapper--2 ds-u-display--none"> <div class="subnav-header"> <span class="back-to-l2 ds-u-lg-display--none">Back to <span class="l2-placeholder"></span> menu</span> <h3 class="subnav-title-h3" style="position:relative;text-align:left;">section title h3</h3> </div> <div class="menu-wrapper"> <ul class="menu"> <li class="menu-item menu-item--l3"> <a href="https://www.healthcare.gov/small-businesses/other-coverage" class="menu-item-element" aria-current="false">Coverage</a> </li> <li class="menu-item menu-item--l3"> <a href="https://www.healthcare.gov/small-businesses/choose-and-enroll/shop-marketplace-overview" class="menu-item-element" aria-current="false">Regulation & guidance</a> </li> <li class="menu-item menu-item--l3"> <a href="https://www.healthcare.gov/small-businesses/choose-and-enroll/qualify-for-shop-marketplace" class="menu-item-element" aria-current="false">Small business tax credit & premium assistance</a> </li> <li class="menu-item menu-item--l3"> <a href="https://www.healthcare.gov/small-businesses/choose-and-enroll/appeal-a-shop-decision" class="menu-item-element" aria-current="false">Appeals</a> </li> <li class="menu-item menu-item--l3"> <a href="/marketplace/employers-sponsors/small-business-health-options-program-shop" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/192901">Small Business Health Options Program (SHOP)</a> </li> <li class="menu-item menu-item--l3"> <a href="/marketplace/employers-sponsors/early-retiree-reinsurance-program" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/191651">Early retiree reinsurance program</a> </li> <li class="menu-item menu-item--l3"> <a href="/marketplace/employer-initiatives" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/192916">Employer initiatives</a> </li> </ul> </div> </div> </li> <li class="menu-item menu-item--l2 menu-item--expanded"> <span class="menu-item-element" aria-current="false">States</span> <div class="subnav-wrapper--2 ds-u-display--none"> <div class="subnav-header"> <span class="back-to-l2 ds-u-lg-display--none">Back to <span class="l2-placeholder"></span> menu</span> <h3 class="subnav-title-h3" style="position:relative;text-align:left;">section title h3</h3> </div> <div class="menu-wrapper"> <ul class="menu"> <li class="menu-item menu-item--l3"> <a href="/marketplace/states/state-marketplace-resources" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/190916">Planning & establishing a Marketplace</a> </li> <li class="menu-item menu-item--l3"> <a href="/marketplace/states/territory-cooperative-agreements" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/190926">Territory cooperative agreements</a> </li> <li class="menu-item menu-item--l3"> <a href="/marketplace/states/early-innovator-program" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/191691">Early innovator program</a> </li> <li class="menu-item menu-item--l3"> <a href="/marketplace/states/state-flexibility-stabilize-market" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/193246">State flexibility to stabilize the Market </a> </li> <li class="menu-item menu-item--l3"> <a href="/marketplace/states/creating-competitive-marketplace" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/192231">Exchange establishment grants</a> </li> <li class="menu-item menu-item--l3"> <a href="https://www.healthcare.gov/coverage/pre-existing-conditions" class="menu-item-element" aria-current="false">Pre-existing condition insurance plan</a> </li> </ul> </div> </div> </li> <li class="menu-item menu-item--l2 menu-item--expanded"> <span class="menu-item-element" aria-current="false">Resources</span> <div class="subnav-wrapper--2 ds-u-display--none"> <div class="subnav-header"> <span class="back-to-l2 ds-u-lg-display--none">Back to <span class="l2-placeholder"></span> menu</span> <h3 class="subnav-title-h3" style="position:relative;text-align:left;">section title h3</h3> </div> <div class="menu-wrapper"> <ul class="menu"> <li class="menu-item menu-item--l3"> <a href="/marketplace/resources/about-us" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/192721">About Us</a> </li> <li class="menu-item menu-item--l3 menu-item--collapsed"> <a href="/marketplace/resources/data" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/191741">Data resources</a> </li> <li class="menu-item menu-item--l3"> <a href="/marketplace/resources/forms-reports-other" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/190966">Forms, reports, & other resources</a> </li> <li class="menu-item menu-item--l3"> <a href="/marketplace/resources/letters" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/191646">Letters</a> </li> <li class="menu-item menu-item--l3"> <a href="/marketplace/resources/regulations-guidance" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/191366">Regulations & Guidance</a> </li> <li class="menu-item menu-item--l3"> <a href="/marketplace/resources/training" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/191466">Training resources</a> </li> </ul> </div> </div> </li> </ul> </div> </li> <li class="menu-item menu-item--l1 menu-item--expanded menu-item--active-trail"> <span class="menu-item-element" aria-current="false">Priorities</span> <div class="subnav-wrapper--1 ds-u-display--none"> <div class="subnav-header"> <span class="back-to-main ds-u-lg-display--none">Back to main menu</span> <h2 class="subnav-title-h2" style="position:relative;text-align:left;width:auto;height:auto;">section title h2</h2> </div> <ul class="menu"> <li class="menu-item menu-item--l2 menu-item--expanded"> <span class="menu-item-element" aria-current="false">Innovation Center</span> <div class="subnav-wrapper--2 ds-u-display--none"> <div class="subnav-header"> <span class="back-to-l2 ds-u-lg-display--none">Back to <span class="l2-placeholder"></span> menu</span> <h3 class="subnav-title-h3" style="position:relative;text-align:left;">section title h3</h3> </div> <div class="menu-wrapper"> <ul class="menu"> <li class="menu-item menu-item--l3"> <a href="/priorities/innovation/overview" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/2090631">Overview</a> </li> <li class="menu-item menu-item--l3 menu-item--collapsed"> <a href="/priorities/innovation/about" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/2074091">About</a> </li> <li class="menu-item menu-item--l3 menu-item--collapsed"> <a href="/priorities/innovation/key-concepts" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/2072461">Key Concepts</a> </li> <li class="menu-item menu-item--l3"> <a href="/priorities/innovation-center/model-data" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/2087691">Model Data</a> </li> <li class="menu-item menu-item--l3 menu-item--collapsed"> <a href="/priorities/innovation-center/value-based-care-spotlight" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/2082926">Value-Based Care Spotlight</a> </li> <li class="menu-item menu-item--l3 menu-item--collapsed"> <a href="/priorities/innovation/models" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/2072436">Innovation Models</a> </li> <li class="menu-item menu-item--l3"> <a href="/priorities/innovation/where-innovation-happening" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/2072451">Where Innovation is Happening</a> </li> <li class="menu-item menu-item--l3 menu-item--collapsed"> <a href="/priorities/innovation/evaluation-research-reports" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/2072446">Evaluations & Research Reports</a> </li> </ul> </div> </div> </li> <li class="menu-item menu-item--l2 menu-item--expanded"> <span class="menu-item-element" aria-current="false">Health Equity</span> <div class="subnav-wrapper--2 ds-u-display--none"> <div class="subnav-header"> <span class="back-to-l2 ds-u-lg-display--none">Back to <span class="l2-placeholder"></span> menu</span> <h3 class="subnav-title-h3" style="position:relative;text-align:left;">section title h3</h3> </div> <div class="menu-wrapper"> <ul class="menu"> <li class="menu-item menu-item--l3 menu-item--collapsed"> <a href="/priorities/health-equity/c2c" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/1974361">Coverage to Care</a> </li> <li class="menu-item menu-item--l3 menu-item--collapsed"> <a href="/priorities/health-equity/minority-health" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/1620916">Minority health</a> </li> <li class="menu-item menu-item--l3 menu-item--collapsed"> <a href="/priorities/health-equity/c2c/es" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/2072591">Cobertura de atención</a> </li> <li class="menu-item menu-item--l3 menu-item--collapsed"> <a href="/priorities/health-equity/grants-awards" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/1612961">Grants & awards</a> </li> </ul> </div> </div> </li> <li class="menu-item menu-item--l2 menu-item--expanded"> <span class="menu-item-element" aria-current="false">Recent Legislation</span> <div class="subnav-wrapper--2 ds-u-display--none"> <div class="subnav-header"> <span class="back-to-l2 ds-u-lg-display--none">Back to <span class="l2-placeholder"></span> menu</span> <h3 class="subnav-title-h3" style="position:relative;text-align:left;">section title h3</h3> </div> <div class="menu-wrapper"> <ul class="menu"> <li class="menu-item menu-item--l3"> <a href="/inflation-reduction-act-and-medicare" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/1621896">Inflation Reduction Act and Medicare</a> </li> <li class="menu-item menu-item--l3"> <a href="/nosurprises" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/1573261">No Surprises Act</a> </li> </ul> </div> </div> </li> <li class="menu-item menu-item--l2 menu-item--expanded menu-item--active-trail"> <span class="menu-item-element" aria-current="false">Key Initiatives</span> <div class="subnav-wrapper--2 ds-u-display--none"> <div class="subnav-header"> <span class="back-to-l2 ds-u-lg-display--none">Back to <span class="l2-placeholder"></span> menu</span> <h3 class="subnav-title-h3" style="position:relative;text-align:left;">section title h3</h3> </div> <div class="menu-wrapper"> <ul class="menu"> <li class="menu-item menu-item--l3"> <a href="/priorities/key-initiatives/opioids" class="menu-item-element" aria-current="false" 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href="/priorities/key-initiatives/burden-reduction/interoperability" title="Interoperability" aria-current="false" data-drupal-link-system-path="node/2096606">Interoperability</a> </li> <li class="menu-item"> <a href="/priorities/key-initiatives/burden-reduction/spotlight" aria-current="false" data-drupal-link-system-path="node/2087686">Spotlight</a> </li> <li class="menu-item"> <a href="/priorities/key-initiatives/burden-reduction/contact-ohei" title="Contact OBRHI" aria-current="false" data-drupal-link-system-path="node/2088026">Contact OHEI</a> </li> </ul></li> </ul></li> </ul></li> </ul> </nav> </div> </inner> </div> <div class="ds-l-col--12 ds-l-md-col--8 ds-l-lg-col--9 cms-global-center"> <inner> <div class="region region-content"> <div data-drupal-messages-fallback class="hidden"></div> <div id="block-cms-evo-pagetitle" class="block block-core block-page-title-block"> <div class="content"> <span class="create-date"> </span> <h1 class="page-title"><span class="field field--name-title field--type-string field--label-visually_hidden">Administrative Simplification <div class="title-border"></div></span> </h1> <div class="title-border"></div> </div> </div> <div id="block-cms-evo-content" class="block block-system block-system-main-block"> <div class="content"> <span class="create-date"> </span> <article class="node node--type-section-page node--view-mode-full clearfix"> <div class="node__content clearfix"> <div class="field field--name-body field--type-text-with-summary field--label-hidden field__item"><article class="media media--type-image media--view-mode-embedded"> <div mid="/files/image/cms2024adminsimphomepagebanner2400png.png-0" class="field field--name-image field--type-image field--label-hidden field__item"> <img src="/sites/default/files/2024-07/cms_2024_adminsimp_homepage_banner_2400.png" width="2400" height="826" alt="An illustration of 3 people keeping graphs, flows, and laptops working" loading="lazy"> </div> </article> <p class="ds-u-padding-top--1">Administrative Simplification works to streamline administrative health care transactions and set standards for transmitting electronic health information. The National Standards Group (NSG) within the Office of Healthcare Experience & Interoperability (OHEI) enforces Administrative Simplification standards, which aim to reduce burden and lower costs by standardizing business practices. </p><p class="ds-u-padding-top--1"><a class="ds-c-button ds-c-button--solid" href="/priorities/key-initiatives/burden-reduction/administrative-simplification/about-administrative-simplification" title="FAQs" data-entity-type="node" data-entity-uuid="5c2d7873-7e78-4587-8708-d2bac539c266" data-entity-substitution="canonical" type="button">Learn More About Us</a></p><div class="ds-l-row ds-u-fill--gray-lightest ds-u-padding-x--2 ds-u-md-padding-x--4 ds-u-lg-padding-x--7 ds-u-lg-padding-y--1 ds-u-margin-top--7 ds-u-margin-x--05"><div class="ds-l-col--12"><div class="ds-u-margin-bottom--3"><div class="ds-l-row"><div class="ds-l-col--12 ds-l-md-col--6 ds-l-lg-col--4 block-menu ds-u-padding-x--1 ds-u-md-padding-x--2 ds-u-margin-y--4 ds-u-display--flex ds-u-flex-direction--column ds-u-justify-content--between"><div><a href="/node/2088866"><article class="media media--type-image media--view-mode-embedded"> <div mid="/files/image/cms2024adminsimphomepageaboutus1280pxpng.png" class="field field--name-image field--type-image field--label-hidden field__item"> <img src="/sites/default/files/2024-05/cms_2024_adminsimp_homepage_aboutus_1280px.png" width="1280" height="1280" alt="Graphic of a doctor holding a clipboard" loading="lazy"> </div> </article> </a><div class=" ds-u-color--primary ds-u-font-weight--semibold ds-u-margin-bottom--2 ds-u-margin-top--2 ds-u-font-size--lead"><a href="/node/2088866">About Us</a></div><div class="ds-u-color--black ds-u-margin-bottom--2 ds-u-margin-top--2">NSG administers HIPAA Administrative Simplification requirements related to the format and content of electronic, administrative health care transactions, such as claims and payments.</div><div class="ds-u-margin-top--3"><div><a class="ds-c-button ds-u-font-size--md" href="/priorities/key-initiatives/burden-reduction/administrative-simplification/about-administrative-simplification" title="HIPAA and Administrative Simplification" data-entity-type="node" data-entity-uuid="5c2d7873-7e78-4587-8708-d2bac539c266" data-entity-substitution="canonical">Learn More</a></div></div></div></div><div class="ds-l-col--12 ds-l-md-col--6 ds-l-lg-col--4 block-menu ds-u-padding-x--1 ds-u-md-padding-x--2 ds-u-margin-y--4 ds-u-display--flex ds-u-flex-direction--column ds-u-justify-content--between"><div><a href="/node/172971"><article class="media media--type-image media--view-mode-embedded"> <div mid="/files/image/cms2024adminsimphomepagehipaa1280pxpng.png" class="field field--name-image field--type-image field--label-hidden field__item"> <img src="/sites/default/files/2024-05/cms_2024_adminsimp_homepage_hipaa_1280px.png" width="1280" height="1280" alt="Graphic of a woman on a laptop, behind her is a Checkbox and the letters HIPAA" loading="lazy"> </div> </article> </a><div class=" ds-u-color--primary ds-u-font-weight--semibold ds-u-margin-bottom--2 ds-u-margin-top--2 ds-u-font-size--lead"><a href="/node/172971">HIPAA and Administrative Simplification</a></div><div class="ds-u-color--black ds-u-margin-bottom--2 ds-u-margin-top--2">HIPAA Administrative Simplification statutory and regulatory provisions include adopted standards and additional requirements for covered entities that conduct electronic health care transactions.</div><div class="ds-u-margin-top--3"><div><a class="ds-c-button ds-u-font-size--md" href="/node/172971" title="HIPAA and Administrative Simplification">Learn More</a></div></div></div></div><div class="ds-l-col--12 ds-l-md-col--6 ds-l-lg-col--4 block-menu ds-u-padding-x--1 ds-u-md-padding-x--2 ds-u-margin-y--4 ds-u-display--flex ds-u-flex-direction--column ds-u-justify-content--between"><div><a href="/node/185366"><article class="media media--type-image media--view-mode-embedded"> <div mid="/files/image/cms2024adminsimphomepagesubregguidance1280pxpng.png" class="field field--name-image field--type-image field--label-hidden field__item"> <img src="/sites/default/files/2024-05/cms_2024_adminsimp_homepage_subregguidance_1280px.png" width="1280" height="1280" alt="Graphic of a male and a female looking away from each other peering into telescopes" loading="lazy"> </div> </article> </a><div class=" ds-u-color--primary ds-u-font-weight--semibold ds-u-margin-bottom--2 ds-u-margin-top--2 ds-u-font-size--lead"><a href="/priorities/key-initiatives/burden-reduction/administrative-simplification/subregulatory-guidance" data-entity-type="node" data-entity-uuid="1521f71b-94c0-4f18-9a1a-23926ef4c62c" data-entity-substitution="canonical" title="Subregulatory Guidance Overview">Subregulatory Guidance</a></div><div class="ds-u-color--black ds-u-margin-bottom--2 ds-u-margin-top--2">This guidance is a line of tools designed to help HIPAA covered entities, their partners, and the health care community comply with statutory and regulatory requirements for standards for electronic health care transactions and operating rules.</div><div class="ds-u-margin-top--3"><div><a class="ds-c-button ds-u-font-size--md" href="/priorities/key-initiatives/burden-reduction/administrative-simplification/subregulatory-guidance" title="HIPAA and Administrative Simplification" data-entity-type="node" data-entity-uuid="1521f71b-94c0-4f18-9a1a-23926ef4c62c" data-entity-substitution="canonical">Learn More</a></div></div></div></div><div class="ds-l-col--12 ds-l-md-col--6 ds-l-lg-col--4 block-menu ds-u-padding-x--1 ds-u-md-padding-x--2 ds-u-margin-y--4 ds-u-display--flex ds-u-flex-direction--column ds-u-justify-content--between"><div><a href="/node/181716"><article class="media media--type-image media--view-mode-embedded"> <div mid="/files/image/cms2024adminsimphomepagetransactions1280pxpng.png" class="field field--name-image field--type-image field--label-hidden field__item"> <img src="/sites/default/files/2024-05/cms_2024_adminsimp_homepage_transactions_1280px.png" width="1280" height="1280" alt="Graphic of a woman interacting with a giant screen" loading="lazy"> </div> </article> </a><div class=" ds-u-color--primary ds-u-font-weight--semibold ds-u-margin-bottom--2 ds-u-margin-top--2 ds-u-font-size--lead"><a href="/node/181716">Transactions</a></div><div class="ds-u-color--black ds-u-margin-bottom--2 ds-u-margin-top--2">Covered entities performing administrative electronic health care transactions must follow Administrative Simplification statutes and regulations, including adopted standards. Learn how these standards are adopted and updated.</div><div class="ds-u-margin-top--3"><div><a class="ds-c-button ds-u-font-size--md" href="/priorities/key-initiatives/burden-reduction/administrative-simplification/transactions" title="HIPAA and Administrative Simplification" data-entity-type="node" data-entity-uuid="12eb5468-1b5b-43e1-86f3-0446dcbca88d" data-entity-substitution="canonical">Learn More</a></div></div></div></div><div class="ds-l-col--12 ds-l-md-col--6 ds-l-lg-col--4 block-menu ds-u-padding-x--1 ds-u-md-padding-x--2 ds-u-margin-y--4 ds-u-display--flex ds-u-flex-direction--column ds-u-justify-content--between"><div><a href="/node/172901"><article class="media media--type-image media--view-mode-embedded"> <div mid="/files/image/cms2024adminsimphomepagecodesets1280pxpng.png" class="field field--name-image field--type-image field--label-hidden field__item"> <img src="/sites/default/files/2024-05/cms_2024_adminsimp_homepage_codesets_1280px.png" width="1280" height="1280" alt="Graphic of a man with a tie who is standing and holding a laptop. Behind him is a giant magnifying glass, magnifying some codes" loading="lazy"> </div> </article> </a><div class=" ds-u-color--primary ds-u-font-weight--semibold ds-u-margin-bottom--2 ds-u-margin-top--2 ds-u-font-size--lead"><a href="/node/172901">Code Sets</a></div><div class="ds-u-color--black ds-u-margin-bottom--2 ds-u-margin-top--2">A code set is a shared list of codes used in place of longer names or explanations. We enforce code sets for diagnoses and procedures used in all electronic health care transactions. </div><div class="ds-u-margin-top--3"><div><a class="ds-c-button ds-u-font-size--md" href="/priorities/key-initiatives/burden-reduction/administrative-simplification/code-sets" title="HIPAA and Administrative Simplification" data-entity-type="node" data-entity-uuid="7e728e4e-d1a9-407a-87f6-83401a44a423" data-entity-substitution="canonical">Learn More</a></div></div></div></div><div class="ds-l-col--12 ds-l-md-col--6 ds-l-lg-col--4 block-menu ds-u-padding-x--1 ds-u-md-padding-x--2 ds-u-margin-y--4 ds-u-display--flex ds-u-flex-direction--column ds-u-justify-content--between"><div><a href="/node/187946"><article class="media media--type-image media--view-mode-embedded"> <div mid="/files/image/cms2024adminsimphomepageoperatingrules1280pxpng.png" class="field field--name-image field--type-image field--label-hidden field__item"> <img src="/sites/default/files/2024-05/cms_2024_adminsimp_homepage_operating_rules_1280px.png" width="1280" height="1280" alt="Graphic of a man sitting on a beanbag with a laptop. There are two pillars in front of him with checkboxes. One has the works "operating rules" on it" loading="lazy"> </div> </article> </a><div class=" ds-u-color--primary ds-u-font-weight--semibold ds-u-margin-bottom--2 ds-u-margin-top--2 ds-u-font-size--lead"><a href="/node/187946">Operating Rules</a></div><div class="ds-u-color--black ds-u-margin-bottom--2 ds-u-margin-top--2">Operating rules are necessary business rules and guidelines for the electronic exchange of information not defined by a standard or its implementation specifications. </div><div class="ds-u-margin-top--3"><div><a class="ds-c-button ds-u-font-size--md" href="/node/187946" title="HIPAA and Administrative Simplification">Learn More</a></div></div></div></div><div class="ds-l-col--12 ds-l-md-col--6 ds-l-lg-col--4 block-menu ds-u-padding-x--1 ds-u-md-padding-x--2 ds-u-margin-y--4 ds-u-display--flex ds-u-flex-direction--column ds-u-justify-content--between"><div><a href="/node/172941"><article class="media media--type-image media--view-mode-embedded"> <div mid="/files/image/cms2024adminsimphomepageenforcement1280pxpng.png" class="field field--name-image field--type-image field--label-hidden field__item"> <img src="/sites/default/files/2024-05/cms_2024_adminsimp_homepage_enforcement_1280px.png" width="1280" height="1286" alt="Graphic of a woman holding a giant gavel. Behind her is a large balance" loading="lazy"> </div> </article> </a><div class=" ds-u-color--primary ds-u-font-weight--semibold ds-u-margin-bottom--2 ds-u-margin-top--2 ds-u-font-size--lead"><a href="/node/172941">Enforcement</a></div><div class="ds-u-color--black ds-u-margin-bottom--2 ds-u-margin-top--2">NSG enforces Administrative Simplification requirements through compliance reviews and responding to complaints of potential noncompliance filed through the Administrative Simplification Enforcement and Testing Tool (ASETT). Learn how you can file a complaint or test a transaction for compliance. </div><div class="ds-u-margin-top--3"><div><a class="ds-c-button ds-u-font-size--md" href="/priorities/key-initiatives/burden-reduction/administrative-simplification/enforcement" title="HIPAA and Administrative Simplification" data-entity-type="node" data-entity-uuid="796b9d22-49a6-46b3-9662-47a00b73c0dd" data-entity-substitution="canonical">Learn More</a></div></div></div></div><div class="ds-l-col--12 ds-l-md-col--6 ds-l-lg-col--4 block-menu ds-u-padding-x--1 ds-u-md-padding-x--2 ds-u-margin-y--4 ds-u-display--flex ds-u-flex-direction--column ds-u-justify-content--between"><div><a href="/node/181996"><article class="media media--type-image media--view-mode-embedded"> <div mid="/files/image/cms2024adminsimphomepageuniqueidentifiers1280pxpng.png" class="field field--name-image field--type-image field--label-hidden field__item"> <img src="/sites/default/files/2024-05/cms_2024_adminsimp_homepage_uniqueidentifiers_1280px.png" width="1280" height="1280" alt="Graphic of a woman in scrubs leaning against a giant phone with a fingerprint on it" loading="lazy"> </div> </article> </a><div class=" ds-u-color--primary ds-u-font-weight--semibold ds-u-margin-bottom--2 ds-u-margin-top--2 ds-u-font-size--lead"><a href="/node/181996">Unique Identifiers</a></div><div class="ds-u-color--black ds-u-margin-bottom--2 ds-u-margin-top--2">Identifier requirements apply to employers and providers to standardize the identification of those conducting electronic health care transactions. </div><div class="ds-u-margin-top--3"><div><a class="ds-c-button ds-u-font-size--md" href="/priorities/key-initiatives/burden-reduction/administrative-simplification/unique-identifiers" title="HIPAA and Administrative Simplification" data-entity-type="node" data-entity-uuid="54cd3a9a-5600-4d29-a1ed-b03263eb5e50" data-entity-substitution="canonical">Learn More</a></div></div></div></div><div class="ds-l-col--12 ds-l-md-col--6 ds-l-lg-col--4 block-menu ds-u-padding-x--1 ds-u-md-padding-x--2 ds-u-margin-y--4 ds-u-display--flex ds-u-flex-direction--column ds-u-justify-content--between"><div><a href="/node/2078891"><article class="media media--type-image media--view-mode-embedded"> <div mid="/files/image/cms2024adminsimpresourcefaq1280pxpng.png" class="field field--name-image field--type-image field--label-hidden field__item"> <img src="/sites/default/files/2024-07/cms_2024_adminsimp_resource_faq_1280px.png" width="1280" height="1280" alt="A woman with a laptop sitting on a laid down question mark" title="FAQ icon" loading="lazy"> </div> </article> </a><div class=" ds-u-color--primary ds-u-font-weight--semibold ds-u-margin-bottom--2 ds-u-margin-top--2 ds-u-font-size--lead"><a href="/training-education/look-up-topics/hipaa-administrative-simplification-resources-and-faqs" data-entity-type="node" data-entity-uuid="c3e27329-824c-48e0-9721-1e0ac9159251" data-entity-substitution="canonical" title="HIPAA Administrative Simplification Resources and FAQs">Resources and FAQs</a></div><div class="ds-u-color--black ds-u-margin-bottom--2 ds-u-margin-top--2"><span class="acronym-highlight">NSG</span><span> has created resources and FAQs on key Administrative Simplification topics. Find them in one convenient location.</span> </div><div class="ds-u-margin-top--3"><div><a class="ds-c-button ds-u-font-size--md" href="/training-education/look-up-topics/hipaa-administrative-simplification-resources-and-faqs" title="HIPAA and Administrative Simplification" data-entity-type="node" data-entity-uuid="c3e27329-824c-48e0-9721-1e0ac9159251" data-entity-substitution="canonical">Learn More</a></div></div></div></div></div></div></div></div><div class="ds-l-row ds-u-padding-x--0 ds-u-md-padding-x--2 ds-u-md-padding-x--4 ds-u-lg-padding-x--7 ds-u-lg-padding-y--1 ds-u-margin-top--5 ds-u-margin-x--05"><div class="ds-l-col--12"><p class="ds-u-font-size--xl ds-u-color--primary ds-u-font-weight--semibold ds-u-margin-bottom--3">Latest Administrative Simplification News & Updates</p></div><div class="ds-l-col--12 ds-l-md-col--6 ds-l-lg-col--3 ds-u-margin-bottom--3"><a class="ds-u-display--block ds-u-margin-bottom--2" href="https://www.youtube.com/watch?v=4foLDmgBwlk">ASETT Demonstration Video</a> <a class="ds-u-text-decoration--none" href="https://www.youtube.com/watch?v=4foLDmgBwlk">Learn More ➜</a></div><div class="ds-l-col--12 ds-l-md-col--6 ds-l-lg-col--3 ds-u-margin-bottom--3"><a class="ds-u-display--block ds-u-margin-bottom--2" href="/files/document/admin-simp-one-pager.pdf">Administrative Simplification One Pager (PDF)</a> <a class="ds-u-text-decoration--none" href="/files/document/admin-simp-one-pager.pdf">Learn More ➜ (PDF)</a></div><div class="ds-l-col--12 ds-l-md-col--6 ds-l-lg-col--3 ds-u-margin-bottom--3"><a class="ds-u-display--block ds-u-margin-bottom--2" href="/files/zip/administrative-simplification-toolkit.zip" data-entity-type="media" data-entity-uuid="2c690873-220d-4021-adde-56751bebae19" data-entity-substitution="canonical" title="Administrative-Simplification-Toolkit">Administrative Simplification Resources Toolkit (ZIP)</a> <a class="ds-u-text-decoration--none" href="/files/zip/administrative-simplification-toolkit.zip" data-entity-type="media" data-entity-uuid="2c690873-220d-4021-adde-56751bebae19" data-entity-substitution="canonical" title="Administrative-Simplification-Toolkit">Learn More ➜ (ZIP)</a></div><div class="ds-l-col--12 ds-l-md-col--6 ds-l-lg-col--3 ds-u-margin-bottom--3"><a class="ds-u-display--block ds-u-margin-bottom--2" href="/files/document/hipaa-admin-simp-fundamentals-fact-sheet.pdf" data-entity-type="media" data-entity-uuid="9111d756-0aa0-41d9-b66c-0e841722ab43" data-entity-substitution="canonical" title="HIPAA Admin Simp Fundamentals Fact Sheet">Administrative Simplification Fundamentals Fact Sheet (PDF)</a> <a href="/files/document/hipaa-admin-simp-fundamentals-fact-sheet.pdf" data-entity-type="media" data-entity-uuid="9111d756-0aa0-41d9-b66c-0e841722ab43" data-entity-substitution="canonical" title="HIPAA Admin Simp Fundamentals Fact Sheet">Learn More ➜ (PDF)</a></div></div><hr><div class="ds-l-row ds-u-display--flex"><div class="ds-l-col--6 ds-l-lg-col--4 ds-u-padding-x--1 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