HIPAA Have Delayed Health Plan Identifiers Indefinitely

The CMS has announced  that the rule that a national health plan identifier must be used for transactions has now been “delayed until further notice”.

The Office of E-Health Standards and Services of the CMS previously decreed in 2012 that it would require health plans to have a numerical identifier, while other covered bodies would also be required to use them and would be included in future mandates.

The Health Insurance Portability and Accountability Act of 1996 uses HPIDs along with other identifiers to simplify management. HIPAA provider IDs were initially introduced in 2007, although plans for the introduction of a national patient identifier have been delayed since 2000 due to privacy and security concerns.

The use of health plan identification numbers has not been greeted with praise by all in the healthcare industry and worry has been voiced that the use of these identifiers would just add granularity; over-complicating transactions unnecessarily. The aim of HPIDs has also been questioned, in particular for the transaction part of the process which industry experts think it to be unnecessary.

The HIPAA official adviser to HHS, the National Committee on Vital and Health Statistics (NCHS), recommended to the CMS earlier this year that it would be advisable to abandon the introduction of a HPID as an alternative enumeration scheme was already in use privately. Since the main focus of HPIDs was to make routing transactions to appropriate payer recipients a simplified process, it makes sense to use a system which is already proving to be successful.

Standardized payer identifiers are already being utilized in private healthcare. These are based on The National Association of Insurance Commissioners’ identifier and the identifiers are used day-to-day. In a communication to HHS Secretary Sylvia Matthews Burwell, NCHS says that the identifiers are “widely used and integrated into all provider, payer and clearinghouse systems. Since these identifiers are in use on a daily basis, making changes would cause major disruption to all administrative transactions.”

The CMS statement comes just before the November 5th deadline for health plans to obtain a HIPD. Use of HPIDs was due to be enforced from Nov 7, 2016.