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CMS Delays Enforcement of Health Plan ID Requirements


November 2014

The Center for Medicare and Medicaid Services (CMS) announced on October 31, 2014 that it is delaying enforcement of the regulations regarding the use of HIPAA health plan identifiers (HPIDs) “until further notice.” The delay applies to all covered entities under HIPAA, including health providers, health plans, and healthcare clearinghouses.

The HPID regulations require group health plans to begin using a unique 10-digit identifier in all standard HIPAA transactions, including claim processing, beginning November 7, 2016. Prior to the enforcement delay, large group plans were required to obtain an HPID from CMS by November 5, 2014; small group health plans (plans with annual receipts of $5 million or less) had until November 5, 2015 to obtain an HPID.

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