Phase 1: Enactment & build · Step 1.3

Build the claims, payment & data systems

Months 0–18, then continuous · UHA Chief Information Officer; MACs; U.S. Digital ServiceDiscuss this step

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Task 1.3.8 of 8

Retire payer-specific claim edits: one national set of coding edits (NCCI) published openly.

Who does it

UHA

When

Month 18

Trade-off

One public set of coding edits ends payer-specific denials but makes the edits a target for providers seeking to game them.

Part of: Build the claims, payment & data systems

Scale Medicare's existing fee-for-service claims infrastructure from about 1.3 billion to about 5 billion claims a year, add hospital global-budget payments, dental and vision claim types, and a national real-time eligibility check.

This step changes 2 existing laws, programs, or institutions. See the list.