The proposed rule announced April 9, 2012 is the third in aseries of regulations over five years that are designed to streamline health care administrative transactions, encourage greater use of standards by health care providers, and make existing standards work more efficiently. HHS proposes adoption of a standard for a unique health plan identifier (HPID), a data element that will serve as an “other entity” identifier (OEID)

The proposed rule was developed by the Office of E-Health Standards and Services (OESS) as part of its ongoing role, delegated by HHS, to adopt standards for electronic health care transactions under HIPAA.  OESS is part of the Centers for Medicare & Medicaid Services (CMS).  The proposed HPID rule would implement an administrative simplification provision of the Affordable Care Act.

Regulation effective date and compliance date

When made final, the effective date of this regulation would be October 1, 2012.

Under the Affordable Care Act, covered entities, excluding small health plans, would be required to be in compliance with the HPID on October 1, 2014. Small health plans would be required to be in compliance with the HPID on October 1, 2015.

HHS also proposes that covered entities have 180 days from the October 1, 2012 effective date of the final rule to comply with the additional NPI requirement.

The proposed rule, CMS-0040-P, may be viewed at www.ofr.gov/inspection.aspx.