HHS releases final rule for health plan identifier, ICD-10

The US Department of Human Health and Services announced a final rule that establishes a health plan identifier required by the Affordable Care Act to help cut red tape in the health care system and save up to $6 billion over 10 years, according to a press release.

The health plan identifier (HPID) is being implemented to solve a number of time-consuming problems health care professionals face when billing a health plan, such as misrouting of transactions, rejection of transactions due to insurance identification errors and difficulty determining patient eligibility.

“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,” Kathleen Sebelius, secretary of the Department of Human Health and Services, said in the release.

The final rule also sets a 1-year delay in the compliance date for use of new International Classification of Diseases (ICD), 10th Edition diagnosis and procedure codes, which will include codes for new procedures and diagnoses that improve the quality of information available for quality improvement and payment purposes. The compliance date was changed from Oct. 1, 2013 to Oct. 1, 2014.

According to the final rule document, “The change in the compliance date for ICD-10 gives covered health care providers and other covered entities more time to prepare and fully test their systems to ensure a smooth and coordinated transition by all covered entities.”

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