Minnesota Administrative Uniformity Committee

The AUC’s mission is to develop agreement among group purchasers and providers on standardized administrative processes when implementation of the processes will reduce administrative costs.

Mission Statement, History and Governing Principles (PDF)

Administrative Uniformity Committee (AUC) ANTITRUST STATEMENT:

The mission of the AUC is to develop agreement among Minnesota health care payers and providers regarding standardized administrative processes, which will reduce administrative costs, and thereby increase the efficiency of health care delivery (Minnesota Statutes, sections. 62J.50 to 62J.61). The AUC Strategic Steering Committee, Operations Committee, Executive Committee, all Technical Advisory Groups, and Work Groups will comply with all applicable antitrust laws during the course of their activities.

The AUC wishes to prevent any situation from which even the appearance of collusion or anti-competitive activity, can be fairly inferred. Therefore, all AUC members are reminded that any action taken to eliminate, restrict, or govern competition among members may be a violation of antitrust laws. Accordingly, at AUC meetings discussion of prices of products, supplies or services is prohibited. Similarly, there must be no discussion of member company or organization operations that might influence pricing, such as, allowances, discounts, terms of sale, margins, operations costs or marketing strategies, that might lead to agreements on customer, geographic or product market allocations; or that might be seen as encouraging a boycott of any person.

Each AUC member is expected to conduct business independently and free from any understandings or agreements or other conduct which may restrain competition. Further, each participant is obligated to speak up immediately to stop any discussion falling outside these bounds.

If you have any questions or antitrust concerns related to the AUC, consult with your legal counsel

The AUC welcomes new members to actively participate and help us work toward standardized administrative processes. The AUC is made up of an Executive Committee, an Operations Committee, and various Technical Advisory Groups (TAGs). Members must appoint two individuals from their organization to serve on the Operations Committee. The AUC Executive Committee consists of payer representative(s) and provider representative(s) who volunteer to serve for a minimum of two years, in an alternating role as chair. Members are also expected to actively participate in various TAGs by appointing at least two individuals from their organization to join in the work.

If you are considering becoming a member, please review the membership criteria in the Mission Statement, History and Governing Principles (PDF) for each TAG and attend an Operations Committee meeting. Prospective member organizations that meet membership criteria can request membership by e-mailing health.auc@state.mn.us. New AUC members are voted on by the Operations Committee.

• Aetna
• Aging Services of Minnesota
• Allina Hospitals and Clinics
• American Association of Healthcare Administrative Management (AAHAM)
• Blue Cross Blue Shield of Minnesota
• Care Providers of Minnesota
• CentraCare Health
• Children's Hospitals and Clinics of Minnesota
• CVS Pharmacy
• Delta Dental Plan of Minnesota
• Essentia Health
• Fairview Health Services
• Grand Itasca Clinic and Hospital
• HealthEast
• HealthEZ
• HealthPartners
• Hennepin County Medical Center
• Mayo Clinic
• Medica
• Metropolitan Health Plan
• Minnesota Chiropractic Association
• Minnesota Council of Health Plans
• Minnesota Dental Association
• Minnesota Department of Health
• Minnesota Department of Human Services
• Minnesota Department of Labor and Industry
• Minnesota HomeCare Association
• Minnesota Hospital Association
• Minnesota Medical Association
• Minnesota Medical Group Management Association
• Minnesota Pharmacist Association
• Olmsted Medical Center
• Park Nicollet Health Services
• PrairieCare
• PreferredOne
• PrimeWest Health
• Ridgeview Medical Center
• Sanford Health
• Sanford Health Plan
• Silverscript
• South Country Health Alliance
• St. Luke's
• UCare Minnesota
• UnitedHealth Group
• University of Minnesota Physicians
• WPS Health Insurance Corporation

As part of the of the Health Care Administrative Simplification Act (ASA) of 1994, the Minnesota Department of Health's (MDH) Center for Health Information Policy and Transformation (CHIPT) develops and implements rules (i.e., Minnesota uniform companion guides) for the standard, electronic exchange of health care administrative transactions pursuant to Minnesota Statutes Section 62J.536 and related rules. This work is being undertaken in consultation with the AUC.

The federal Centers for Medicare & Medicaid Services (CMS) has recently issued two notices of proposed rulemaking (NPRM) of possible interest. CMS is seeking public comments on both of the NPRM. The AUC will not be submitting comments but members and interested parties are encouraged to review the NPRM and to submit their own comments if desired and as instructed in the NPRM.

• Notice of Proposed Rulemaking (NPRM) CMS-0056-P

  Title of proposed rule: Administrative Simplification: Modifications of Health Insurance Portability and Accountability Act of 1996 (HIPAA) National Council for Prescription Drug Programs (NCPDP) Retail Pharmacy Standards; and Adoption of Pharmacy Subrogation Standard

  What This Proposed Rule Would Do

  This proposed rule, if finalized, would modify the currently adopted National Council for Prescription Drug Programs (NCPDP) D.0 standard to the Telecommunications Standard Implementation Guide Version F6 (F6) and Batch Standard Implementation Guide Version 15, and adopt the NCPDP Batch Standard Subrogation Implementation Guide Version 10. The proposed rule would also broaden the applicability of the Medicaid pharmacy subrogation transaction to all health plans. To that end, the rule would rename and revise the definition of the transaction and adopt an updated standard, which would be a modification for state Medicaid agencies and an initial standard for all other health plans.

  Public Comment Period

  There is a 60-day public comment period for this rule, which closes on January 9, 2023. Instructions for submitting comments can be found at Notice of Proposed Rulemaking (NPRM) CMS-0056-P.

• Notice of Proposed Rulemaking (NPRM) CMS–0057–P (PDF)

  Title of proposed rule: CMS Medicare and Medicaid Programs; Patient Protection and Affordable Care Act; Advancing Interoperability and Improving Prior Authorization Processes for Medicare Advantage Organizations, Medicaid Managed Care Plans, State Medicaid Agencies, Children’s Health Insurance Program (CHIP) Agencies and CHIP Managed Care Entities, Issuers of Qualified Health Plans on the Federally Facilitated Exchanges, Merit-Based Incentive Payment System (MIPS) Eligible Clinicians, and Eligible Hospitals and Critical Access Hospitals in the Medicare Promoting Interoperability Program

  CMS proposes to modernize the health care system by requiring certain payers to implement an electronic prior authorization process, shorten the time frames for certain payers to respond to prior authorization requests, and establish policies to make the prior authorization process more efficient and transparent. The rule also proposes to require certain payers to implement standards that would enable data exchange from one payer to another payer when a patient changes payers or has concurrent coverage, which is expected to help ensure that complete patient records would be available throughout patient transitions between payers.

  CMS proposals include requiring implementation of a Health Level 7® (HL7®) Fast Healthcare Interoperability Resources® (FHIR®) standard Application Programming Interface (API) to support electronic prior authorization, as well as requirements for certain payers to include a specific reason when denying requests, publicly report certain prior authorization metrics, and send decisions within 72 hours for expedited (i.e., urgent) requests and seven calendar days for standard (i.e., non-urgent) requests.

  In addition, this proposed rule would add a new Electronic Prior Authorization measure for eligible hospitals and critical access hospitals under the Medicare Promoting Interoperability Program and for Merit-based Incentive Payment System (MIPS) eligible clinicians under the Promoting Interoperability performance category.

  Public Comment Period: There is a 90-day public comment period for this rule, which closes on March 13, 2023. Instructions for submitting comments can be found at Notice of Proposed Rulemaking (NPRM) CMS–0057–P (PDF)

Due to the competing demands of the COVID pandemic, the AUC is suspending activities and meetings through at least the first quarter of 2022. There are currently no AUC meetings scheduled for 2022 and meeting information will be added when available.