Quality

The effective date on which a specific healthcare regulation became enforceable or applicable. Used in compliance management systems to determine when regulated entities became subject to a mandate, enabling accurate tracking of compliance obligations, grace periods, and historical regulatory applicability across reporting periods.

The blood oxygen saturation level defined as a regulatory threshold or clinical benchmark within a healthcare compliance rule, such as mandated monitoring requirements for specific patient populations. Used in quality reporting and regulatory compliance tracking where SpO2 measurements are tied to required clinical interventions or reporting obligations.

The monetary value paid in connection with a regulatory compliance event, such as a regulatory fee, penalty payment, or mandated reimbursement tied to a specific legal requirement. Used in financial and compliance reporting to track payments made to or received from regulatory bodies in fulfillment of statutory obligations.

The date on which a payment associated with a regulatory compliance obligation was processed, such as the date a regulatory fee, penalty, or mandated reimbursement was remitted. Used in financial compliance tracking to confirm timely fulfillment of monetary obligations required under specific healthcare regulations.

The higher-level regulation to which a specific sub-regulation or derived rule belongs within a hierarchical regulatory framework. Used to organize complex regulatory structures, such as federal statutes that contain multiple subordinate rules or state regulations that derive authority from broader federal mandates.

A percentage-based threshold or parameter defined within a specific healthcare regulation, such as a mandated medical loss ratio, required cost-sharing percentage, or minimum actuarial value requirement. Used in compliance calculations and reporting to validate that plans, claims, or financial arrangements meet regulatory percentage-based standards.

The defined time interval over which a specific healthcare regulation applies or is measured, such as a benefit year, reporting quarter, or compliance review cycle. Used to scope compliance calculations, reporting obligations, and regulatory thresholds to the correct timeframe as specified by the applicable mandate.

The primary telephone contact number associated with a regulatory compliance record, such as the phone number for a regulatory agency, oversight body, or designated compliance contact. Used to facilitate direct communication regarding regulatory requirements, compliance inquiries, or enforcement activities related to a specific healthcare mandate.

Identifies the specific healthcare benefit plan associated with a regulatory requirement or compliance obligation. Used in plan administration to link regulatory mandates such as ACA, ERISA, or state insurance requirements to the applicable benefit plan structure for compliance tracking and reporting.

The unique identifier assigned to a specific regulatory policy or compliance requirement within healthcare administration systems. Used to reference and track mandates such as state insurance regulations, CMS requirements, or federal healthcare laws across plan administration and compliance workflows.

The standardized display name assigned to a specific healthcare regulation or compliance requirement. Used in regulatory reporting and compliance systems to present the regulation in a consistent, human-readable format across dashboards, audit trails, and plan administration documentation.

The monetary value associated with meeting a specific regulatory compliance requirement in healthcare, such as fees, penalties, or mandated benefit costs. Used in financial and compliance systems to track expenditures tied to regulatory obligations including CMS mandates or state insurance requirements.

A flag designating whether a specific regulation is the primary compliance requirement governing a healthcare plan or benefit. Used in plan administration systems to distinguish principal regulatory mandates from secondary or supplemental requirements when multiple regulations apply to the same plan or benefit.

A ranking value indicating the relative enforcement urgency or compliance precedence of a specific healthcare regulation. Used in compliance management systems to sequence regulatory obligations, allocate resources, and determine the order in which mandates such as CMS rules or state insurance laws must be addressed.

A monitoring metric representing the current activity or compliance status frequency of a specific healthcare regulation. Used in regulatory tracking systems to capture how actively a mandate is being enforced, updated, or reviewed, supporting compliance teams in maintaining timely responses to regulatory changes.

The numeric count or volume associated with a specific regulatory compliance requirement in healthcare, such as the number of affected members, covered services, or required filings. Used in compliance reporting systems to measure the scope of regulatory obligations across health plans or benefit programs.

The racial or ethnic classification criteria specified within a healthcare regulation for purposes of equity reporting, population health compliance, or mandated demographic data collection. Used in compliance and quality reporting systems to satisfy regulatory requirements such as HEDIS, CMS equity measures, or state health disparity mandates.

The defined minimum and maximum value boundaries established by a healthcare regulation for a specific compliance metric, such as allowable cost thresholds, benefit limits, or clinical quality measure targets. Used in compliance systems to validate whether plan performance or benefit designs fall within regulatory parameters.

The per-unit or frequency-based value specified by a healthcare regulation, such as a mandated reimbursement rate, required coverage ratio, or compliance metric threshold. Used in plan administration and financial systems to apply regulatory rate requirements from sources such as CMS fee schedules or state insurance mandates.

A scored or tiered assessment value assigned to a healthcare regulation reflecting its compliance complexity, risk level, or organizational impact. Used in regulatory management systems to prioritize compliance efforts, assign accountability, and track performance against mandates such as star ratings, accreditation standards, or state insurance requirements.