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2024 Review Work Group

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Overview

The 2024 Review Work Group (RWG) will review and refine the updated draft Eligibility & Benefits Operating Rule requirements. Review of the draft rule by the RWG is a critical step in the CORE Voting Process and requires a formal ballot with a quorum of 60% of participating organizations and a simple majority approval.

Announcements

No announcements for this work group

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Staff

Taha Anjarwalla

CAQH CORE

Bob Bowman

CAQH CORE

Pete Benziger

CAQH CORE

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Co-Chairs

Donna Campbell

Health Care Service Corporation

Margaret Schuler

Aspen Dental

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Members

Matt Louden

HIVE Strategy

Catherine Chen

HIVE

matt louden

HIVE Strategy

Jaclyn Leiser

CAQH CORE

Donna Campbell

Health Care Service Corporation

Susan Langford

BlueCross BlueShield of Tennessee

Bob Bowman

CAQH CORE

Sudheer Tummala

Blue Cross and Blue Shield of North Carolina

Margaret Weiker

National Council for Prescription Drug Programs (NCPDP)

Margaret Brown

Healthedge Software Inc

Taha Anjarwalla

CAQH CORE

Althea Robinson

TCS

Tammy Vicari

TCS

Kristina Steece

Ameritas

Maria Lagoutis

Unitedhealthcare

Leah Barber

Availity

Charles Hawley

National Association of Health Data Organizations (NAHDO)

Pete Benziger

CAQH CORE

Olga Khabinskay

Healthcare Business Management Association

Margaret Schuler

Aspen Dental

Meredith Ray

Cigna

C Veverka

Michigan Department of Community Health

Noah Mastel

Ameritas

Shannon Kennedy

Sekhmet Advisors

Emma Andelson

American Medical Association

Amy King

BCBSMI

Nancy Hyde

Michigan Medicaid

Lorna Bradley

Sekhmet Advisors

Paul Chupp

Ameritas

Rebekah Fiehn

ADA

Jason Large

UHC

Simha Gandhi

Lassie

Paula Smith

CMS

Naomi Miao

athenahealth

Suzanne Droste

Mayo Clinic

Evi Russo

athenahealth

Ana Isabella

Cigna

Kristin Tahai

Cigna

Marina Collins

Optum

Kimberly Konyshak

Availity

Sharon Nichols

Availity

BreAnne Davenport

DaVita

Kristin Leasiolagi

DaVita

Rachel Gold

Golds Health

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Calendar

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CORE Eligibility & Benefits Task Group Call #5
09/05/2024
Topic: CORE Eligibility & Benefits Task Group Call #5
  • Discuss results of Straw Poll #3 on Bundled Payments and Contractual "Carve-outs"
  • Level set on draft rule requirements
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EBTG Call #4
08/01/2024
Topic: CORE Eligibility & Benefits Task Group Call #4
  • Introduce Use Case #4: value-based care
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EBTG Call #3
07/11/2024
Review and discussion of EBTG Straw Poll #1 on medication covered by the medical benefit and EBTG Straw Poll #2 on dental benefits results.

Upcoming Events

No events are scheduled at this time. Please check back later.

Past Events

09/05/2024 6:00 - 7:00 pm ET

CORE Eligibility & Benefits Task Group Call #5

Topic: CORE Eligibility & Benefits Task Group Call #5

  • Discuss results of Straw Poll #3 on Bundled Payments and Contractual "Carve-outs"
  • Level set on draft rule requirements

08/01/2024 6:00 - 7:00 pm ET

EBTG Call #4

Topic: CORE Eligibility & Benefits Task Group Call #4

  • Introduce Use Case #4: value-based care

07/11/2024 6:00 - 7:30 pm ET

EBTG Call #3

Review and discussion of EBTG Straw Poll #1 on medication covered by the medical benefit and EBTG Straw Poll #2 on dental benefits results.

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Documents

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At a Glance_CORE Eligibility & Benefits Data Content Operating Rule vEB.2.1_RWG Ballot

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DRAFT_CORE Eligibility & Benefits (270_271) Data Content Rule vEB.2.1_RWG Ballot

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DRAFT_Appendix_CORE Eligibility & Benefits (270_271) Data Content Rule vEB.2.1_RWG Ballot

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20241031_CORE RWG Call #2

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20241003_CORE RWG Call #1

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