Solicitation, QA/QC
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Chapter Element
10.01 Medicare Administrative Contractor (MAC) QASP Performance Requirements
10.02 Behavioral Health - Medicaid IT Architecture (BH-MITA) State Self-Assessment (SS-A)
10.03 Head Start Program
10.04 CMS 21 - State Expenditure Reporting for Medicaid & CHIP
10.05 Medicare Part C - D - Contractor (42 CFR 422.503(b)(4)(vi)(A) - 42 CFR 423.504(b)(4)(vi)(A))
10.06 Comprehensive Child Welfare Information System (CCWIS) Project Requirements
10.07 Medicaid Enterprise Certification Toolkit (MECT) 2.1
10.08 Federal Acquisition Regulations (FAR) - Part 46 Quality Assurance
10.09 Administration for Children and Families - CFR-45 Part 1355
10.10 Administration for Children - Youth and Families - CFR-45 Part 1357
10.11 Health Insurance Portability and Accountability Act (HIPPA)
10.12 Program Stage 3: Electronic Protected Health Information (ePHI)
10.13 Title 42 Part 431 State Organization and General Administration
10.14 State Plans for Medical Assistance - Sec. 1902 (42 U.S.C. 1396a)
10.15 OMB Circular A-87 - Cost Principles for State - Local and Indian Tribal Governments
10.16 OMB A-130 Management of Federal Resources
10.17 OMB A-133 - HHS Compliance
10.18 45 CFR Part 80 - 84 - 86 - 91 Compliance
10.19 Governmental Accounting Standards Board (GASB)
10.20 NIST SP-800-181 NICE Cybersecurity Workforce Framework
10.21 Medicare Fee-For-Service Contractors
10.22 NIST SP 800-40r3 - Patch Management
10.23 45 CFR Part 75 - Subpart F (Audit Requirements)
10.24 GAO-18-568G - Generally Accepted Government Auditing Standards (GAGAS)
10.25 US Insurance Financial Solvency Framework and Core Principles
10.26 NAIC - Establishment of Exchanges and Qualified Health Plans
10.27 NAIC - Health Benefit Plan Network Access and Adequacy Model Act (Admendment Pending)
10.28 NAIC - Health Financial Analysis
10.29 45 CFR 156.275 - Accreditation of Qualified Health Plan (QHP)
10.30 Medicaid and CHIP Payment and Access Commission (MACPAC) - 2019 Guidance
10.31 CFR Title 42 Part 1001 - Program Integrity - Medicare and State Health Care Programs
10.32 Sec. 1927 42 U.S.C. 1396r-8 - Payment for Covered Outpatient Drugs (Admendment Pending MACPAC )
10.33 Sec. 1905. 42 U.S.C. 1396d - Grants to States for Medical Assistance Programs
10.34 Sec. 1902. 42 U.S.C. 1396a - State Plans for Medical Assistance
10.35 Sec. 304B - Public Health Service Act
10.36 FDA Sec. 501-503 - Food - Drug and Cosmetic Act
10.37 Sec. 1923 42 U.S.C. 1396r-4 - Medicaid Disproportionate Share Hospital (DSH) Payments
10.38 42 CFR 433.139 - Payment of Claims
10.39 CMS-2198-F - General Disproportionate Share Hospital (DSH) Audit and Reporting Protocol
10.40 42 CFR 447.45 - Timely Claims Payment
10.41 45 CFR Part 164 - Security and Privacy
10.42 42 CFR Part 455 - Program Integrity Medicaid
10.43 42 CFR Part 438 - Managed Care (Subpart A-K)
10.44 NAIC - Network Adequacy Regulatory Requirements and Oversight
10.45 45 CFR Part 155 - Exchange Establishment Standards under the Affordable Care Act
10.46 42 U.S.C. 1320a-7b(b) - Anti-Kickback Statute (AKS)
10.47 31 U.S.C. 3729-3733 - False Claims Act (FCA)
10.48 42 U.S.C. 1320a-7 - Exclusion of certain individuals and entities from participation in Medicare and State health care programs
10.49 42 U.S.C. 1395nn - Physician Self-Referral Law (Stark law)
10.50 45 CFR 164.526 - Amendment of Protected Health Information
10.51 Go Live - Electronic Health Record (EHR)
10.52 Cyber Resilience Review - Self Assessment
10.53 Pandemic Influenza Risk and Impact Management
10.54 Business Pandemic Influenza Planning
10.55 Electronic Health Record (EHR) Testing Plan
10.56 Electronic Health Record (EHR) System Configuration