HIPAA HPID Use Opposed American Hospital Association

by | Jul 26, 2015

This week, the Vice President and Deputy Director of the American Hospital Association (AHA) sent a correspondence to the Centers for Medicare & Medicaid Services (CMMS) revealing concern over the implementation of Health Plan Identification numbers (HPIDs) and Other Entity Identifiers (OEIDs).

When HIPAA was brought in, it required national identification numbers to be used by healthcare providers, health plans and people. A national ID number was introduced in 2004, although the IDs were only for providers, not people.

In September 2012, the HPID proposed rule was released, although it took until November 2014 before the rule was finalized. HPIDs and OEIDs will now be required to be adhered to for HIPAA transactions from Nov 7, 2016. It is not a requirement for health plans to be identified in HIPAA transactions, but if they are, from Nov 7, next year a HPID must be adhere to.

The letter, sent on behalf of Ashley Thompson to Andy Slavitt, the acting administrator for CMMS, stated the AHAs opposition to HIPDs & OEIDs. Thompson revealed “The intent of the HIPAA legislation was to reduce administrative costs and make the process more efficient; the adoption of the HPID within the HIPAA transaction standards does neither.” The fear is that the use of the ID numbers will inflict a huge administrative burden on HIPAA-covered entities, but will not provide many benefits.

Many healthcare plans already have plenty of HPIDs but the process of validating those IDs is not easy. In the letter Thompson points out that many health plans have more than 60 HPIDs. Adding to that number would just “create disruption and confusion to the existing system that routes claims.”

A long time has passed since the idea of HPIDs was first proposed, and in the years that followed healthcare suppliers have taken steps to ensure claims are routed properly. The methods being used may not be standardized, but they do ensure claims are properly submitted.

HIPAA compliance already necessitates a considerable amount of resources, and the addition of HPID/OEID is seen as an added burden. In the correspondence, Thompson said, “The AHA recommends that the Department of Health and Human Services (HHS) revise the final rule to prohibit use of the HPID/OEID within a HIPAA transaction”. Thompson believes the HHS should “allow the use of existing mechanisms to identify health plans.”

While Thompson was critical of the use of HPIDs for HIPAA transactions, she said the AHA was not against the use of HPIDs and other identification numbers in general. Thompson said “We support alternate uses of the HPID by CMS, such as to implement the certification program for health plan compliance or for adherence to operating rules for HIPAA transactions.”

This use of HPIDs would be advantageous, as it would allow healthcare providers to determine which health plans are in compliance with HIPAA transaction standards. It has been recommended that this use of HPIDs should be in place no later than December of this year.

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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:

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