HHS Proposes Rescinding Standard Unique Health Plan Identifier

January 2019 ~

On December 19, the Department of Health and Human Services (HHS) issued a proposed rule, Administrative Simplification: Rescinding the Adoption of the Standard Unique Health Plan Identifier and Other Entity Identifier, to rescind the standard unique health plan identifier (HPID) and the other entity identifier (OEID), along with related implementation specifications and requirements for their use.

The original rule, entitled Administrative Simplification: Adoption of a Standard for a Unique Health Plan Identifier (45 CFR Part 162), was published on September 5, 2012 and included plans to:

  • Adopt the HPID as the standard unique identifier for health plans
  • Define the terms “Controlling health plan” (CHP) and “Subhealth plan” (SHP)
  • Require all covered entities to use an HPID whenever a covered entity identifies a health plan in a covered transaction
  • Adopt a data element serving as an OEID for entities that are not health plans, individuals, or health care providers

Following publication of the final rule, the Health Plan and Other Entity Enumeration System (HPOES) was deployed in October of 2012 and 11,000 HPID’s and 99 OEID’s were enumerated through October 2014. Shortly after HHS issued a statement delaying enforcement of the HPID regulation to consider recommendation.

Several hearings were held (2014, 2015, and 2017) with the National Committee on Vital and Health Statistics (NCVHS) and the HHS advisory body to assess the regulation’s impact on the industry.

Based on the input from the NCVHS and the HHS advisory body as well as feedback gathered from a 2015 Request for Information (RFI), HHS said the identifiers do not add value to electronic health care transactions and would be “costly, complicated and burdensome” to implement, noting that the field already has satisfactory mechanisms to route claims and other HIPAA transactions using the existing payer IDs.

The agency will accept comments on the proposed rule through February 19, 2019.

Source(s): CMS; Federal Register; Health Industry Washington Watch; HealthPayerIntelligence; American Hospital Association;