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New HHS Rule Meets HIPAA Standard


Keeping up with changes in the health care industry is an ongoing process. As health care organizations transition to the cloud and increasingly use electronic health records and electronic medical records, changes must be made. The latest change comes courtesy of the U.S. Department of Health and Human Services (HHS).

On Aug. 24, 2012, according to a fact sheet issued by, HHS announced

A final rule … HHS adopts the standard for a national unique health plan identifier (HPID) and a data element that will serve as an “other entity” identifier (OEID). This is an identifier for entities that are not health plans, health care providers, or individuals, but that need to be identified in standard transactions. The rule also specifies the circumstances under which an organization-covered health care provider, such as a hospital, must require certain non-covered individual health care providers who are prescribers to obtain and disclose a National Provider Identifier (NPI).

The final rule was developed by the Office of E-Health Standards and Services (OESS) as part of its ongoing role, delegated by HHS, to adopt standards for electronic health care transactions under the Health Insurance Portability and Accountability Act of 1996 (HIPAA). OESS is part of the Centers for Medicare & Medicaid Services (CMS). The adoption of the HPID implements an administrative simplification provision of the Affordable Care Act.

“These new standards are a part of our efforts to help providers and health plans spend less time filling out paperwork and more time seeing their patients,” said HHS Secretary Kathleen Sebelius in a press release on the HHS website.

“Currently, when a health care provider bills a health plan, that plan may use a wide range of different identifiers that do not have a standard format. As a result, health care providers run into a number of time-consuming problems, such as misrouting of transactions, rejection of transactions due to insurance identification errors, and difficulty determining patient eligibility. The change announced today will greatly simplify these processes,” says the Aug. 24 press release.

Do you have any questions on how these changes may impact your Healthcare IT support, EMR and EHR programs or any other way your your healthcare clinic uses IT? Give us a call and we can help you make sense of it all.

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