HIPAA Final Rule: Enforcement: Four Penalty Tiers

February 21, 2013. Today, we examine the four penalty tiers for violations of HIPAA Rules in the Final Rule: Modifications to the HIPAA Privacy, Security, Enforcement, and Breach Notification Rules Under the Health Information Technology for Economic and Clinical Health Act [HITECH Act] and the Genetic Information Nondiscrimination Act; Other Modifications of the HIPAA Rules, which was published in the Federal Register on January 25, 2013. The effective date of the Final Rule is March 26, 2013, and covered entities and business associates must comply by September 23, 2013. Tomorrow, we look at the relationship of FERPA and HIPAA vis-a-vis disclosure of immunization records to schools, with a return to enforcement Monday and Tuesday of next week.

Final Administrative Simplification Rules for Plan ID, NPI Addition, and ICD-10 Code Set Compliance Delay Published in Federal Register

September 5, 2012. Today, the Federal Register published the Centers for Medicare & Medicaid Services (CMS) Final Rule: Administrative Simplification: Adoption of a Standard for a Unique Health Plan Identifier; Addition to the National Provider Identifier [NPI] Requirements; and a Change to the Compliance Date for the International Classification of Diseases, 10th Edition (ICD-10-CM and ICD-10-PCS) Medical Data Code Sets. We provided the detailed “Executive Summary” in our August 24, 2012 posting, based on the preview posting at the Federal Register’s Electronic Public Inspection Desk. In this posting, we provide the shorter publication “Summary.”

CMS Issues Final Administrative Simplification Final Rules Regarding Identifiers and ICD-10 Code Set Compliance Delay

August 24, 2012. Today, the Office of Management and Budget (OMB) completed review and sent to the Federal Register for publication on September 5, 2012, the Centers for Medicare & Medicaid Services (CMS) Final Rule: Administrative Simplification: Adoption of a Standard for a Unique Health Plan Identifier; Addition to the National Provider Identifier Requirements; and a Change to the Compliance Date for the International Classification of Diseases, 10th Edition (ICD-10-CM and ICD-10-PCS) Medical Data Code Sets. The effective date of the Rule is November 5, 2012. Prior to publication on September 5, the Final Rule may be examined at or downloaded from the Office of the Federal Register’s Electronic Public Inspection Desk.

HHS Publishes NPRM for HIPAA Health Plan Identifier and Delay for ICD-10 Compliance Date

April 17, 2012. The Office of the Secretary of the Department of Health and Human Services (HHS) published today in the Federal Register its Notice of Proposed Rule Making (NPRM): Administrative Simplification: Adoption of a Standard for a Unique Health Plan Identifier; Addition to the National Provider Identifier Requirements; and a Change to the Compliance Date for ICD-10-CM and (CD-10-PCS Medical Data Code Sets. HHS invites comments on this NPRM, to be received no later than 5 PM on Thursday, May 17, 2012. Instructions for submitting comments are provided in the NPRM.

HHS Issues HIPAA NPRM for Unique Health Plan Identifier and One Year Delay for ICD-10 Code Set Compliance

April 10, 2012. Yesterday, the Office of the Secretary of the Department of Health and Human Services (HHS) promulgated a notice of proposed rule making (NPRM) entitled: Administrative Simplification: Adoption of a Standard for a Unique Health Plan Identifier; Addition to the National Provider Identifier Requirements; and a Change to the Compliance Date for ICD-10-CM and ICD-10-PCS Medical Data Code Sets. The NPRM will be published in the Federal Register on April 17, 2012. Comments may be submitted to HHS for 30 days after publication. HHS indicates that “[w]hen made final, the effective date of this regulation would be October 1, 2012.”

National Provider Identifier Final Rule

This final rule establishes the standard for a unique health identifier for health care providers for use in the health care system and announces the adoption of the National Provider Identifier (NPI) as that standard. It also establishes the implementation specifications for obtaining and using the standard unique health identifier for health care providers. The implementation specifications set the requirements that must be met by “covered entities”: Health plans, health care clearinghouses, and those health care providers who transmit any health information in electronic form in connection with a transaction for which the Secretary has adopted a standard (known as “covered health care providers”). Covered entities must use the identifier in connection with standard transactions.  The use of the NPI will improve the Medicare and Medicaid programs, and other Federal health programs and private health programs, and the effectiveness and efficiency of the health care industry in general, by simplifying the administration of the health care system and enabling the efficient electronic transmission of certain health information. This final rule implements some of the requirements of the Administrative Simplification subtitle F of the Health Insurance Portability and Accountability Act of 1996 (HIPAA).

Employer Identifier Final Rule

This final rule establishes a standard for a unique employer identifier and requirements concerning its use by health plans, health care clearinghouses, and health care providers. The health plans, health care clearinghouses, and health care providers must use the identifier, among other uses, in connection with certain electronic transactions.  The use of this identifier will improve the Medicare and Medicaid programs, and other Federal health programs and private health programs, and the effectiveness and efficiency of the health care industry in general, by simplifying the administration of the system and enabling the efficient electronic transmission of certain health information. It will implement some of the requirements of the Administrative Simplification subtitle of the Health Insurance Portability and Accountability Act of 1996. 