HIPAA Have Delayed Health Plan Identifiers Indefinitely

by | Nov 2, 2014

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.

Raise the level of HIPAA Awareness in your organization with Learner-Friendly, Comprehensive and Affordable HIPAA Training.


Please enable JavaScript in your browser to complete this form.

Patrick Kennedy

Patrick Kennedy is a highly accomplished journalist and editor with nearly two decades of experience in the field. With expertise in writing and editing content, Patrick has made significant contributions to various publications and organizations. Over the course of his career, Patrick has successfully managed teams of writers, overseeing the production of high-quality content and ensuring its adherence to professional standards. His exceptional leadership skills, combined with his deep understanding of journalistic principles, have allowed him to create cohesive and engaging narratives that resonate with readers. A notable area of specialization for Patrick lies in compliance, particularly in relation to HIPAA (Health Insurance Portability and Accountability Act). He has authored numerous articles delving into the complexities of compliance and its implications for various industries. Patrick's comprehensive understanding of HIPAA regulations has positioned him as a go-to expert, sought after for his insights and expertise in this field. Patrick's bachelors degree is from the University of Limerick and his master's degree in journalism is from Dublin City University. You can contact Patrick through his LinkedIn profile:

Raise the level of HIPAA Awareness in your organization with Learner-Friendly, Comprehensive and Affordable HIPAA Training.

Comprehensive HIPAA Training

Used in 1000+ Healthcare Organizations and 100+ Universities

    Full Course - Immediate Access

    Privacy Policy