Both rules have been transmitted to the Office of Management and Budget for review, which is one of the last steps before publication, although there is no timetable for OMB action. Both rules are mandated under the Affordable Care Act.
The health plan identifier originally was mandated in 1996 under the HIPAA law but never implemented. In addition to reviving the plan identifier, the reform law enacted in 2010 also had additional HIPAA transactions provisions. These included new electronic transactions for electronic funds transfer and claims attachments, and new “operating rules” to further standardize all HIPAA transactions.
The state health insurance exchanges are envisioned to increase competition in the insurance marketplace and give small businesses the same purchasing clout as large businesses, according to HHS.
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