AUC Logo

Minnesota AUC Administrative Simplification
 

Administrative Uniformity Committee
Mission Statement, History and Governing Principles

Updated March 2010

Printable Mission (pdf 8 pages)

1.  Definitions:

For purposes of this document, the following definitions apply:
Group purchaser has the meaning given in Minnesota Statutes, section 62J.03, subdivision 6 as follows:
"Group purchaser" means a person or organization that purchases health care services on behalf of an identified group of persons, regardless of whether the cost of coverage or services is paid for by the purchaser or by the persons receiving coverage or services, as further defined in rules adopted by the commissioner. “Group purchaser” includes, but is not limited to, community integrated service networks; health insurance companies, health maintenance organizations, nonprofit health service plan corporations, and other health plan companies; employee health plans offered by self-insured employers; trusts established in a collective bargaining agreement under the federal Labor-Management Relations Act of 1947, United States Code, title 29, section 141, et seq.; the Minnesota Comprehensive Health Association; group health coverage offered by fraternal organizations, professional associations, or other organizations; state and federal health care programs; state and local public employee health plans; workers' compensation plans; and the medical component of automobile insurance coverage.
Provider has the meaning given in Minnesota Statutes, sections 62J.03, subdivision 8 as follows:

“Provider” or “health care provider” means a person or organization other than a nursing home that provides health care or medical care services within Minnesota for a fee and is eligible for reimbursement under the medical assistance program under chapter 256B. For purposes of this subdivision, “for a fee” includes traditional fee-for-service arrangements, capitation arrangements, and any other arrangement in which a provider receives compensation for providing health care services or has the authority to directly bill a group purchaser, health carrier, or individual for providing health care services. For purposes of this subdivision, “eligible for reimbursement under the medical assistance program” means that the provider's services would be reimbursed by the medical assistance program if the services were provided to medical assistance enrollees and the provider sought reimbursement, or that the services would be eligible for reimbursement under medical assistance except that those services are characterized as experimental, cosmetic, or voluntary.

2.  Mission:

To develop agreement among group purchasers and providers on standardized administrative processes when implementation of the processes will reduce administrative costs.

3.  History:

The Administrative Uniformity Committee (AUC) started as a broad-based group representing Minnesota health care public and private payers, hospitals, physicians, other providers and State agencies.  The impetus for its establishment came from the Minnesota Council of Health Plans, whose member plans committed in 1991 to standardize their administrative processes and requirements with the goal of reducing administrative costs for both payers and providers. Recognizing that costs can be reduced effectively only if all major stakeholders are involved, the Council’s committee sought the endorsement and active participation of other payers, state agencies, and representatives of key provider groups.  By mid-1992, virtually all groups contacted had offered their enthusiastic support and had named representatives to the committee.  The expanded AUC agreed that the initial priority was to respond to the MinnesotaCare health care reform mandates. Although the AUC originally reported to the Minnesota Council of Health Plans, today the AUC is an independent entity with whom the Commissioner of the Minnesota Department of Health (MDH) is required to consult for purposes of Minnesota Statutes, sections 62J.50 to 62J.61. The AUC may also from time to time act as a consulting body to other public and private entities.

4.  Purpose and Objectives:

4.1  To develop agreement among group purchasers and providers regarding uniform billing forms, uniform claims procedures, unique identifiers, and uniform electronic billing procedures in order to reduce health care administrative costs for the industry;

4.2 To participate actively in the implementation of standardization plans enacted as part of health care reform.  It is understood that implementation will be a multi-year process;

4.3  To function as a consulting body on matters related to the AUC’s mission statement;

4.4  To continue research into new issues that may lead to enhanced administrative uniformity and bring issues and recommendations to private industry and/or governmental entities;

4.5  To undertake educational efforts and facilitate the members’ understanding about how the different stakeholders address specific administrative simplification issues.

5.  Membership:

5.1  Criteria:  In order to be considered for membership in the AUC, an individual must represent a stakeholder as defined in this paragraph.  A stakeholder must: (1) be a provider, association, society, group purchaser, or governmental organization; and, (2) be capable of implementing recommendations and decisions of the AUC.  Each stakeholder will be entitled only to one vote, even if represented by more than one member at any given meeting unless the organization is both a group purchaser and provider in which case the organization would have two votes. Any provider organization governed by separate and distinct Boards of Directors can apply for an independent vote as stated in section 5.3 below. Membership of provider associations will be evaluated on a case-by-case basis taking into account size, geographic representation, specialty and so forth.

5.2  Roster: The members and liaison groups of the AUC shall be those persons or organizations listed on the AUC roster.  The MDH staff shall be responsible for maintaining the roster and keeping it up-to-date. 

5.3  New member approval:  Organizations that wish to be AUC members must qualify as a stakeholder as defined in paragraph 5.1 and request membership in writing to the AUC.  The request will be presented to the AUC at the next scheduled meeting and voted on at the following meeting.  New members and stakeholders will be subject to approval by a two-thirds majority vote of stakeholders represented at a meeting.

6.  AUC Structure:

6.1  The AUC is made up of three committees: a Strategic Steering Committee, an Executive Committee and an Operations Committee.
6.1.1  The AUC Strategic Steering Committee will be comprised of executives from voting member organizations and members of the Governor’s Health Care Cabinet. The AUC Strategic Steering Committee will provide strategic direction and establish priorities for the work of the AUC. The members of this committee will provide the necessary resources to support the work of the AUC and ensure implementation of AUC solutions within their organizations.

6.1.2  The role of the AUC Executive Committee is to ensure efficient and effective communication between the AUC Operations Committee, AUC TAGs and AUC Strategic Steering Committee. The AUC Executive Committee will deliver the strategic direction from the AUC Strategic Steering Committee to the AUC Operations Committee. The AUC Executive Committee will bring issues and recommendations from the AUC Operations Committee to the Strategic Steering Committee. The AUC Executive Committee will be in charge of planning all AUC Strategic Steering Committee meetings, agendas, and all communications with the Strategic Steering Committee. The AUC Executive Committee shall be responsible for developing and circulating AUC Operations meeting agendas. AUC members may submit agenda items to the chair a reasonable amount of time in advance of the meeting.

6.1.3  The AUC Operations Committee will define all strategies and new uniformity opportunities. The AUC Operations Committee will approve all Technical Advisory Group (TAG) work products.
6.2  AUC Executive Committee:
6.2.1  The AUC Executive Committee members shall be comprised of the following five voting members: the current AUC Chair, the current co-chair, the immediate past chair; and the chairs from the two Executive Technical Advisory Groups (TAGs). Membership also includes a non-voting representative from the Minnesota Department of Health. The Executive Committee must strive for balance with equal representation from the group purchaser and provider community. For example, if the Chair represents a group purchaser organization, then the Co-Chair should represent a provider organization. In the even that either the Chair, Co-Chair, or past Chair were to resign midterm from the AUC, then a person from that representative’s industry should be selected to fill the remainder of that term. The Executive Committee must strive to achieve the same kind of balance between the provider and group purchaser community among the two chairs of the Executive TAGs.

6.2.2  The AUC Executive Committee will review the need for new Operations TAGs and prepare a recommendation for the AUC Operations Committee. The AUC Executive Committee will evaluate the effectiveness of all TAGs.

6.2.3  The AUC Executive Committee will have two Executive TAGs – Membership/Policy and Procedures, and Communications and Marketing, – that report to the Executive Committee. Each of these Executive TAGs will have a chair and a co-chair. Each chair will serve as a member of the AUC Executive Committee and will have a one-year term. Each co-chair will become the chair of the respective Executive TAG at the end of the chair’s term. Once the co-chair becomes the Chair of the Executive TAG, the new chair now serves on the AUC Executive Committee. To the extent possible, the chair and co-chair positions shall rotate representation from the group purchaser and provider sector of the industry. The Chairs of the Executive TAGs must be members of the AUC Operations Committee.

6.2.4  The Membership/Policy and Procedure Executive TAG is responsible for issues related to AUC membership and the development of all AUC policies and procedures. This Executive TAG will develop a job description for AUC members, review the membership of all TAGs to ensure all AUC member organizations are represented on the TAGs as needed, and will review member attendance and make recommendations to the AUC Executive Committee. This Executive TAG will develop documentation for AUC by-laws, chair rotation duties and rules, standard TAG documentation and reports for the AUC, policies and procedures related to legislation and issue development. Current approved policies can be found at the AUC website.

6.2.5  The Communications and Marketing Executive TAG is responsible for all AUC communications and marketing. This Executive TAG will be responsible for the AUC website, AUC newsletters and updates, and news releases. The membership for this TAG will be business and communications experts from AUC member organizations. This TAG will have 10-12 members.

6.2.6  AUC Executive Committee meetings will be open to the public.
6.3  AUC Operations Committee:
6.3.1  The AUC Operations will annually elect a chair and co-chair. Nominees for the chair and co-chair positions must come from the voting membership. It is the intent of the committee to rotate the chair position between representatives from group purchaser and provider organizations. AUC Operations members making nominations should consider this before the nomination is made. At the end of the chair’s one-year-term, the co-chair will automatically be elected chair for the coming year. The chair, in conjunction with the MDH staff, shall be responsible for maintaining the AUC Operations meeting schedule and membership roster. The chair shall also be responsible for chairing AUC Operations meetings. The co-chair will be responsible for chairing those meetings, which the chair cannot attend, and it is the chair’s responsibility to coordinate with the chair-elect to ensure that at least one of them is present at each meeting. The chair and co-chair will serve on the AUC Executive Committee.
6.4  Operations Meeting/Agenda
6.4.1  Unless the members agree otherwise, the AUC Operations Committee’s standing meetings shall be from 2:00 to 4:00 p.m. on the second Tuesday of every month. If the second Tuesday follows a holiday, then the AUC will meet on the third Tuesday.

6.4.2  All AUC Operations Meetings will be open to the public.

6.4.3  During the other business portion of the meeting, any attendee can bring forward an issue or proposal.

6.4.4  The last item of business for each meeting will be to confirm the time and location of the next meeting.

6.5  AUC Operations Technical Action Groups (TAGs):
6.5.1  The AUC Operations Committee may from time to time establish one or more subgroups, which are called Operations Technical Advisory Groups (TAGs).

6.5.2  Unless otherwise determined by the AUC, membership in an Operations TAG shall be open both to (1) AUC members or representatives of the member organization that can implement the Operations TAG’s recommendations or decisions and (2) those who can offer technical expertise to the Operations TAG. Only AUC members may vote, and each member organization shall be limited to one vote, regardless of how many of its representatives are in attendance at any particular meeting.

6.5.3  The Operations TAG members shall elect co-chairs for the Operations TAG at the first meeting. One Operations TAG Co-Chair should represent a group purchaser organization and the other co-chair should represent a provider organization, if possible. One of the co-chairs should be an AUC-Operations member. If a TAG co-chair is not able to continue to serve in this role, the Operations TAG membership shall elect a new co-chair representing the same sector of the industry. Terms of the Operations TAG co-chairs will be 1 year or the project term., whichever is less.

6.5.4  All AUC Operations TAG meetings will be open to the public.

7.  Participation Requirements:

7.1  Participation in all AUC meetings can be in person, by phone, or by sending an alternate.

7.2 Every AUC member organization must have executive representation on the AUC Strategic Steering Committee

7.3  Every AUC member organization must have a primary and secondary representative for the Operations Committee.

7.4  Every AUC member organization must participate on at least two technical advisory groups (TAGs) or TAG workgroups.

7.5  Every AUC member organization must participate in at least 2/3 of the meetings of SSC, Operations and 2 TAGs/WGs

7.6  Participation requirements will be reviewed quarterly by the Membership/P&P TAG according to policy #004.

8.  The Minnesota AUC will use the following guidelines for reaching final decisions:

8.1  Consistent with the overall spirit of the statute, the AUC, its TAGs and Work Groups will always strive to achieve unanimous consensus on all its decisions.

8.2  Given the type of work involved in developing the companion guides (review of each loop/segment/element/data value) and the master project timeline, it will not be feasible, nor would it be practical, to take formal voting actions at each and every one of the data element-level decisions being made at the Work Group level.  Thus, Work Groups will review and reach consensus while going through each of the loops/segments/elements/data values of the HIPAA Implementation Guide.

8.3  Once the review process is completed, if there are no outstanding consensus issues, the Work Group will make an informal motion and polling of participating members to recommend the work product to the corresponding TAG.

8.4  If there are outstanding consensus issues, the Work Group may choose to attempt to resolve them and achieve full consensus on the companion guide (via informal motion and polling of participating members), or choose to document them, offer alternative solutions, the pros and cons of each solution, and the ‘majority/ minorities’ views, and formally adopt the work product with outstanding consensus issues.

9.   Formal Motion and Voting Mechanism (applicable to TAGs and Operations Committee):

9.1  Work Groups of TAGs will provide their work products to the corresponding TAG with a recommendation for approval or the TAG may delegate authority to the workgroup as stated in AUC Policy #009.

9.2  Approved/completed work products will be presented to the Operations Committee for review and discussion with voting to occur at the following meeting unless communicated otherwise by the AUC Chair and Co-Chair.

9.3  In making a formal decision to approve a recommendation or decision by a TAG and/or the Operations Committee, the following parameters will be:

9.3.1  The Co-Chairs of the TAGs or the Operations Group will follow Robert’s Rules of Order in taking formal action regarding a work product, including hearing a formal motion, a second, opening the floor for discussion and debate, calling the vote, and conducting a formal voice vote. 

9.3.2  If vote is unanimous, it will be so noted.

9.3.3  If the vote is not unanimous, a vote count will be recorded.  Final approval is then achieved if the following rule is met: a simple majority (50% + 1) of all eligible group purchaser members and, at the same time, a simple majority (50% + 1) of all eligible provider members that are present cast a vote in favor of the motion.  As a “non-voting action”, abstentions will not count against or in favor of the final voting estimation.

9.3.4  In the case of a non-unanimous vote, the group will need to identify the outstanding consensus issues, alternative solutions, pros and cons of those solutions, and record the majority and minority/minorities views.

9.3.5  An email vote will be conducted when time constraints arise due to the schedule of the Operations Committee, TAG or workgroup that would result in a delay of necessary work to be completed by the AUC or if a quorum is not reached at an AUC Operations meeting as outlined in AUC Policy #011.

9.4  All work products completed by the Minnesota AUC that will be delivered to the Department of Health for review, approval, and adoption via publication in the State Register (or for potential changes to Minnesota Statutes, section 62J) must either have achieved consensus approval of the Administrative Uniformity Operations Committee, or will be presented to the commissioner with supporting documentation regarding the outstanding issues, alternate solutions, and the voting outcome of member organizations.

Back to top

 
 Most Viewed