An entity seeking or holding certification must demonstrate the expertise and arbitration experience of its reviewers, procedures for timely determinations, a conflict-of-interest screening process covering material familial, financial and professional relationships and affiliation with plans, issuers, providers or trade associations, a published fee schedule within the allowed range, trust or escrow arrangements for fees, a process to keep individually identifiable health information confidential and to notify the Departments and affected parties of breaches, accreditation or equivalent, and general and professional liability coverage; must attest annually, report each month the number of initiations, determinations, prevailing parties, amounts and fees, and retain records for 6 years; and is subject to audit, suspension and revocation of certification.
The graph holds this control, the 0 it maps to, and the evidence behind each claim, over MCP and REST.