Skip to Main Content

Events and Latest News

Provider Pilot Program

The CMS Division of National Standards, on behalf of HHS, is launching 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 will select 3 health care providers from the pool of volunteers to participate. To learn more about how to volunteer to participate, visit the Compliance Review Program webpage.

Compliance Review Program

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

In April 2019, HHS will randomly select 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. In 2019, providers will be able to participate in a separate pilot program on a voluntary basis.

Version D.0 Notice of Proposed Rulemaking

The Department of Health and Human Services (HHS) announces the Notice of Proposed Rulemaking (NPRM) CMS-0055-P that was recently published in the Federal Register. This NPRM proposes to modify the requirements for the use of the Telecommunication Standard Implementation Guide, Version D, Release 0 (Version D.0), August 2007, National Council for Prescription Drug Programs (NCPDP) by requiring HIPAA covered entities to use the Quantity Prescribed field (460-ET) for retail pharmacy transactions for Schedule II drugs. 

There is a 60-day public comment period for this rule, which closes on April 1, 2019. We encourage our stakeholders to read this proposed rule and submit comments, as these will assist us in preparing the final rule.

Read the full Information Bulletin on the Go-to-Info page for more information.

Health Plan Identifier and Other Entity Identifier Notice of Proposed Rulemaking

The Department of Health and Human Services (HHS) announces the December 19, 2018, Federal Register publication of the notice of proposed rulemaking (NPRM) CMS-0054-P pertaining to the Administrative Simplification provisions of the Health Insurance Portability and Accountability Act of 1996 (HIPAA). This NPRM proposes to modify 45 CFR 162.103 and repeal 45 CFR 162.502-514 to eliminate the regulatory requirement for health plans to obtain and use an HPID, as well as eliminate the voluntary acquisition and use of the OEID.  The proposed rule would also simplify the process for terminating the existing identifiers to minimize operational costs for covered entities. 

There is a 60-day public comment period for this rule, which closes on February 19, 2019.  We encourage our stakeholders to read this proposed rule and submit comments, as these will assist us in preparing the final rule.  During the comment period, and until a final rule is published, the enforcement discretion remains in effect for all covered entities. 

Keep Up to Date!