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The request has been submitted to the federal register by the Department of Health and Human Services (HHS) inviting comments from the public on the HPID Final Rule, to determine whether changes are required to make the ID scheme more workable. The deadline for those comments has been set for July 28. Any covered entity – or individual – must submit comments before this date in order for them to be considered. It is the last opportunity to have a say in how the scheme will operate.
Background to The HIPAA HPIDs
The Health Insurance Portability and Accountability Act (HIPAA) – Section 262, Public Law 104–191 – amended the Social Security Act requiring the HHS to introduce a new national identification scheme for health plans, with each needing to be issued with a unique Health Plain ID number (HPID).
Under the Patient Protection and Affordable Care Act, the HHS was required to release a final rule on the use of HPIDs by health plans, which was initially scheduled for October 1, 2012. However, in September, 2012 an Administrative Simplification was released along with a new compliance deadline for the introduction of new ICD-10 codes; which came into effect on November 5, 2014. Small health plans were given an extension to the deadline and were not required to obtain and use a HPID until November 5, 2015.
In order to differentiate between different types of health plan, a structure was devised which separated controlling health plans (CHPs) and subhealth plans (SHPs), the former requiring a HPID and the latter not. An additional category was also created, OEID – other entity ID – which could be used by non-health plans that needed to have HIPAA transactions identified.
There is no requirement for the HPIDs to be used if the health plan is not identified in the transaction, but if it is, the new HPID must be used. The deadline for using an HPID in a HIPAA transaction was set as November 7, 2016.
However, the HPID scheme has stalled. A number of hearings took place in 2014 which highlighted problems with the use of HPIDs, and the HHS made the decision to “exercise enforcement discretion” – under 45 CFR 162, Subpart E – with enforcement of HPID use delayed until further notice. This was intended to allow the HHS time to review comment from the National Committee on Vital and Health Statistics (NCVHS), which recommend the release of further clarification on the use of HPIDs.
The HHS is now inviting the public to comment on the recommendations made by NCVHA, in addition to HPID use under the ACA. A lot has changed in the healthcare industry since the HPID Final Rule was issued, and feedback is required to determine whether amendments are now necessary.
HHS Requests Comments on HPID Final Rule
There are three key areas where comment is invited:
- The use of CHP, SHP and OEID categories and the enumeration structure of the HPID Final Rule
- The use of Payer IDs and HPIDs for HIPAA transactions
- Opinion on HPID use in light of developments in the healthcare industry since the release of the HPID Final Rule
The HHS will consider all comments received before the deadline date of July, 28, 2015.