CMS Proposes New Identifier & Delaying ICD-10 Until October of 2014

Home Health Proposed Rule 2013.

CMS published a proposed rule today that would:

  • Establish a unique health plan identifier (HPID) under Health Insurance Portability and Accountability Act of 1996 (HIPAA) standards for electronic health care transactions.  CMS states this change would save the health care industry up to $4.6 billion over ten years by enabling greater automation of electronic health care transactions, in turn helping physicians spend less time interacting with health plans — and more time with patients.
  • Adopt a data element that would serve as an “other entity” identifier (OEID) for entities that are not health plans, health care providers, or individuals, but that need to be identified in standard transactions. The rule proposes an addition to the National Provider Identifier (NPI) requirements.
  • Specifies the circumstances under which an organization covered health care provider must require certain non-covered individual health care providers who are prescribers to obtain and disclose an NPI.
  • Delay by one year, until Oct. 1, 2014, the date by which covered entities must comply with International Classification of Diseases, 10th Edition diagnosis and procedure codes (ICD-10). Some provider groups had expressed serious concerns about their ability to meet the October 1, 2013 compliance date. CMS and HHS believe the change in the compliance date for ICD-10, as proposed in this rule, would give providers and other covered entities more time to prepare and fully test their systems to ensure a smooth and coordinated transition among all industry segments.

Agencies have 30 days to submit comments.

HEALTHCAREfirst will keep you up to date on additional information as it is posted.