Regulatory Compliance

QMetrics offers numerous regulatory compliance services such as implementing new state and federal requirements across health plan operational areas, preparing for and responding to regulatory surveys, launching new product lines, and developing and enhancing internal compliance monitoring.

We provide guidance, interpretation assistance, and rapid-cycle implementation of complex current and new laws such as the No Surprises Act and the California Department of Managed Health Care (DMHC) Mental Health Parity and Addiction Equity Act (MHPAEA).

Our suite of services include:

  • Compliance assessment, development and training in areas such as:
    • California Knox-Keene Act
    • Covered California requirements
    • Federal requirements (ACA, Medicare, HIPAA, No Surprises Act)
    • Compliance Program requirements
    • Implementation plans for new laws
  • No Surprises Act Legislative Implementation Guide for California – Effective 1/1/2022
  • Mental Health Parity and Addiction Equity Act (MHPAEA) guidance & filing assistance
  • Regulatory audit readiness assessments and Mock Audits
  • Creation and implementation of Delegation Oversight Programs
  • Policy and procedure assessments and operational gap analysis
  • Launch of new products or newly licensed plans
  • Regulatory filing assistance

Contact us at on how we can help ensure your organization’s compliance house is in order.