Health plans may continue to engage in healthcare transactions without using unique health plan identifiers (“HPIDs”)—at least for now. The Department of Health and Human Services (“HHS”) announced it would indefinitely delay enforcement of regulations that would have required health plans to obtain and use Health Plan Identifiers in HIPAA transactions as early as November 5, 2014.
The announcement follows recommendations by the National Committee on Vital and Health Statistics (“the commission”) that HHS not require covered entities to use HPIDs in administrative transactions, and that it clarify when and how HPIDs would be used in health plan compliance certification under the Affordable Care Act.
The commission, an HHS Advisory Body, surveyed stakeholders in the healthcare industry, only 15% of which found any value in the use of HPIDs in healthcare transactions. While HPIDs were developed in the mid-1990s to facilitate the routing of transactions to appropriate payer recipients, the commission noted that this rationale may be outdated. “The industry has moved to the implementation of a standardized national payer identifier,” one that is widely used and integrated into all provider, payer and clearinghouse systems.
Although the commission expressed concern about disrupting the routing and processing of administrative transactions reliant on payer IDs, it also noted that HPIDs have been given other purposes, “including use in other CMS programs such as insurance exchanges/ marketplaces and with health plan compliance certification under the Affordable Care Act.”
The delay allows HHS to consider the committee’s recommendations and consider next steps.