Events and Latest News

Health Plan Identifier Final Rule

The Department of Health & Human Services (HHS) has published in the Federal Register the Final Rule CMS-0054-F pertaining to the Administrative Simplification provisions of the Health Insurance Portability and Accountability Act of 1996 (HIPAA). 

This final rule eliminates the regulatory requirement for health plans to obtain and use an HPID and eliminates the voluntary acquisition and use of the OEID. The final rule also simplifies the process for deactivating the existing identifiers to minimize operational costs for covered entities. 

For more information, read the full Information Bulletin on the Go-to-Info page.

Learn How to File a HIPAA Transaction Complaint

If you believe a HIPAA-covered entity is not complying with transaction, code set, unique identi­fier, or operating rule requirements, you can file a complaint through ASETT. To learn how, read the How to File a Complaint Infographic  (PDF).

CMS Process for HIPAA Administrative Simplification Compliance

CMS enforcement of HIPAA Administrative Simplification requirements includes proactive enforcement through the Compliance Review Program.  Find out how CMS conducts compliance reviews with the Compliance Review Infographic  (PDF).

HIPAA Administrative Simplification Complaints

One of the ways CMS enforces HIPAA Administrative Simplification requirements is investigating complaints submitted by the health care community. Learn more about this type of enforcement with the Complaint Process Infographic (PDF). 

Provider Pilot Program

The CMS Division of National Standards, on behalf of HHS, has launched a volunteer Provider Pilot Program to test the compliance review process and to gain insights on compliance with HIPAA Administrative Simplification rules among providers. This follows a successful pilot program for health plans and clearinghouses completed in 2018.

In April 2019, HHS selected 3 health care providers from the pool of volunteers to participate. Results of the pilot will be posted when available.

Compliance Review Program

The CMS Division of National Standards, on behalf of HHS, has launched the Compliance Review Program to ensure compliance among covered entities with HIPAA Administrative Simplification rules for electronic health care transactions.

In April 2019, HHS randomly selected 9 HIPAA-covered entities—a mix of health plans and clearinghouses—for Compliance Reviews. Any health plan or clearinghouse—not just those who work with Medicare or Medicaid—may be selected. In 2018, HHS piloted the program with health plan and clearinghouse volunteers to streamline the compliance review process and identify any system enhancements. 

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Page Last Modified:
10/28/2019 10:17 AM