American Benefits Council
Benefits Byte

2014-015

March 3, 2014

The Benefits Byte is the American Benefits Council’s regular e-mail and online newsletter for members only, providing timely reports on legislative, regulatory and judicial developments, along with updates on the Council’s activities in support of employer-sponsored benefit plans.

The Benefits Byte is published by the American Benefits Council, based on staff reports and edited by Jason Hammersla, Council director of communications. Contact information for Council staff related to specific topics can be found at the end of each story.

Click here to read past issues on the Benefits Byte Archive page.

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Deadline Postponed for Comments on HIPAA Compliance Certification Proposed Rules

The U.S. Department of Health and Human Services (HHS) has formally postponed the deadline for submission of comments on proposed regulations establishing new requirements for certification of compliance with the administrative simplification provisions of HIPAA. The deadline, previously set for March 3, has been extended to April 3, 2014.

Under the administrative simplification provisions of HIPAA, covered entities are required to conduct certain transactions electronically using standards and code sets designated by HHS. Transactions subject to these requirements include eligibility, claims & encounter information, claims status, enrollment and disenrollment, payment, premium payment and coordination of benefits. In addition to adding new transactions, The Patient Protection and Affordable Care Act (PPACA) mandated that health plans submit certain documentation and information to HHS that demonstrates compliance with electronic transaction standards and established new penalties for health plans that fail to comply.

Under the HHS proposed regulations, issued January 2, health plans that are “controlling health plans” (a definition added by prior final regulations implementing the unique health plan identifier (HPID) requirements of HIPAA) must submit: (1) documentation that demonstrates compliance using one of two available methods; and (2) its number of covered lives on the date. These requirements apply with respect to three transactions: eligibility for a health plan, health care claim status and health care electronic funds transfer and remittance advice. Under the proposed regulations, the required documentation and information will be due December 31, 2015. Additional background regarding HIPAA administrative simplification and the proposed regulations are included in a summary provided courtesy of Groom Law Group. The Council also held a P4P … Preparing for PPACA webinar on February 21; to obtain a recording, please contact Jason Hammersla here.

The Council is preparing a comment letter and continues to welcome your feedback. For more information or to provide input for the comment letter, contact Kathryn Wilber, senior counsel, health policy, at (202) 289-6700.



The American Benefits Council is the national trade association for companies concerned about federal legislation and regulations affecting all aspects of the employee benefits system. The Council's members represent the entire spectrum of the private employee benefits community and either sponsor directly or administer retirement and health plans covering more than 100 million Americans.

Notice: the information contained herein is general in nature. It is not, and should not be construed as, accounting, consulting, legal or tax advice or opinion provided by the American Benefits Council or any of its employees. As required by the IRS, we inform you that any information contained herein was not intended or written to be used or referred to, and cannot be used or referred to (i) for the purpose of avoiding penalties under the Internal Revenue Code, or (ii) in promoting, marketing or recommending to another party any transaction or matter addressed herein (and any attachment).