The federal government continues to struggle with implementation of a national health plan identifier, first mandated under HIPAA in 1996 and again in the Affordable Care Act in 2010.
A final rule in 2012 adopted a standard for a unique health plan identifier, also called HPID. Most health plans were required to have an HPID by Nov. 5, 2014, with small plans having another year to comply. The rule also distinguished between controlling health plans that needed an HPID and subhealth plans that did not.
Further, providers are not required to identify a health plan in a HIPAA transaction, but if they do identify the plan they must use the HPID.
Still, doubts have lingered on the value of the plan identifier when used with HIPAA electronic transactions, promoting a new request for information from the Department of Health and Human Services.
The advisory group National Committee on Vital and Health Statistics in late 2014 recommended to HHS that HPID not be used in HIPAA transactions. HHS soon after the recommendation delayed enforcement of the rule.
Now, the request for information, available here, seeks comments on the HPID enumeration structure and use of supporting concepts, such as controlling health plans and subhealth plans, as well as another optional identifier called OEID for non-covered entities that need to be identified in HIPAA transactions.
HHS also seeks comment on use of HPID in HIPAA transactions in conjunction with the Payer ID, and whether recent changes in the healthcare system have changed perspectives on the function of HPID.
The request for information is available here with a 60-day comment period starting May 29.
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