Industry News

HHS Publishes Final Rule for a Unique Health Plan Identifier and to Delay ICD-10 Implementation.

The Department of Health and Human Services (HHS) recently published a final rule that will establish a unique health plan identifier (HPID) and “other entity” identifier (OEID) for other entities that perform health plan functions.

HHS expects the HPID and OEID identifiers to simplify certain administrative functions for health plans, including routing transactions and determining patients’ eligibility. Under the final rule, other entities such as health care clearinghouses, third party administrators, and repricers, will have a separate form of identification from health plans. Use of the new identifiers should result in a savings of $1.3 to $6 billion over the next ten years.

In addition, the fine rule clarifies the particular circumstances under which health care organizations must require noncovered health care providers to disclose a National Provider Identifier (NPI). Further, HHS finalized the implementation deadline for the International Classification of Diseases, 10th Edition (ICD-10) diagnosis coding. Providers will now have until October 1, 2014 to comply with the new ICD-10 coding requirements.

The HPID Final Rule will take effect on November 5.

The HPID Final Rule is available at:

Administrative Simplification: Adoption of a Standard for a Unique Health Plan Identifier; Addition to the National Provider Identifier Requirements; and a Change to the Compliance Date for the International Classification of Diseases, 10th Edition (ICD-10-CM and ICD-10-PCS) Medical Data Code Sets, 45 Fed. Reg. 162, 54664, 54664 (Sep. 5, 2012).