March 3, 2014
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.