HHS Withdraws Proposed Rule for Certification of Compliance for Health Plans

Early in 2014 the HHS proposed a new rule for certification of compliance for health plans that would have meant all those managing health plans (CHPs) to complete a range of documentation to HHS to show compliance with electronic transaction standards set by the HHS under HIPAA Rules.

The proposed rule rule was aimed at to supporting more consistent testing processes for CHPs. The HHS has now revealed that the proposed rule has now been withdrawn from condiseration.

Had it made it to the final rule stage, CHPs would have been asked to demonstrate compliance with HIPAA administration simplification standards for three electronic transactions: Eligibility for a health plan, health care claim status,and health care electronic funds transfers (EFT) and remittance guidance. The inability to adhere with the new rule would have resulted in fines for CHPs.

Most employers’ health care plans were managed by their insurance carriers, so the proposed rule would not have affected them directly, although significant stress would have been placed on self-funded employers by the rule amendment. After publication of the proposed rule in the federal register in January 2014, HHS was sent over 72 public comments. After reviewing those comments, the HHS made the decision to kill the proposed rule change.

HHS will be the issues raised in the comments and will be incestigating options and alternatives to adhere with statutory requirements.

Speaking recently the Secretary of the HHS explained that rules have already been established for compliance with HIPAA administration simplification standards and enforcement of compliance with those standards. While the proposed rule has been withdrawn, the HHS has revealed that covered groups are still required to adhere with 45 CFR parts 160 and 162.

Author: Security News