HHS Proposes Unique Health Plan Identifier, Delays Compliance Date for ICD-10

On April 17, 2012, HHS published a proposed rule that would to postpone the date by which certain health care entities have to comply with International Classification of Diseases, 10th Edition (ICD-10) diagnosis and procedure codes from October 1, 2013 to October 1, 2014. HHS notes that many provider groups have expressed concerns about their ability to meet the 2013 compliance date; the extension is intended to give covered entities more time to prepare and fully test their systems to ensure a smooth transition to these new code sets. This compliance delay would be accompanied by an extension of the limited freeze on updates to the code sets. The rule also would implement section 1104 of the ACA by establishing new requirements for administrative transactions that are intended to improve the utility of the existing HIPAA transactions and reduce administrative burden and costs. Specifically, the rule would: adopt a standard for a unique health plan identifier (HPID); adopt a data element that would serve as an “other entity” identifier (OEID) for entities that are not health plans, health care providers, or “individuals” that need to be identified in standard transactions; and specify the circumstances under which an organization covered health care provider must require certain noncovered individual health care providers who are prescribers to obtain and disclose a National Provider Identifier (NPI). HHS estimates that the proposed changes would save health care providers and health plans up to $4.6 billion over the next ten years. Comments on the rule will be accepted until May 17, 2011.

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