CMS Delays HIPAA Health Plan Identifiers Deadline

The Centers for Medicare & Medicaid Services (CMS) issued a new rule demanding a National Health Plan Identifier must be attached to all healthcare transactions. However as the HIPAA health plan identifiers deadline is fast approaching, the CMS has made the decision to delay the initiative.

The original HIPAA health plan identifiers deadline was November 5th, 2014, with the enforcement date set as Nov 7, 2016. According to a recent statement by the CMS, its plans have been “delayed until further notice”.

With so many healthcare transactions taking place, it would be impossible to keep track of them all without some method of identification. Numeric indicators were introduced back in 2007, and have helped with administration as more covered entities have adopted EHRs and made the transition to digital records.

However, different identification systems for different transactions can make for administrative headaches, so a new National Health Plan Identifier ID was devised in 2000. The CMS however was not able to progress with its plans due to numerous privacy and security concerns, although its Office of E-Health Standards and Services did rule that a system would be required.

The CMS has also been criticized for the planned introduction of the HIPAA health plans identifiers (HPIDs). While in theory an HPID would simplify administration, it is feared that in practice it would just add granularity. Many critics have said that HIPAA is complicated enough without unnecessarily complicating matters further with another ID system.

It now appears that the CMS may be reconsidering its plans rather than delaying the HIPAA health plan identifiers deadline. The National Committee on Vital and Health Statistics (NCHS) advised the CMS that it would be wise not to pursue its planned HPIDs any further, backing up other critics’ claims of the system just adding granularity.

It was a case of not needing to reinvent the wheel. Covered entities had their own systems for identifying patients and transactions and everything was working reasonably smoothly. While the plan was to simplify transactions with a new system, the CMS was advised to just work with the system that was currently in place.

The NCHS told HS Secretary Sylvia Matthews Burwell: ”Since these identifiers are in use on a daily basis, making changes would cause major disruption to all administrative transactions.” For the time being at least, healthcare providers will not have to contend with a new national health plan ID number.

Author: Richard Anderson

Richard Anderson is the Editor-in-Chief of