News and Updates

HIPAA Transaction Standards Rule Proposal Could Come Soon

(July 18, 2008)

Upgrades to new versions of standards expected

The Centers for Medicare & Medicaid Services (CMS) has sent a proposed rule that would adopt new versions of standards for electronic claiming to the Office of Management and Budget (OMB).  We are expecting the Notice of Proposed Rule Making (NPRM) would propose adoption of the ASC X12N version 5010 set of standards for electronic claims, remittance advices, and other transactions standardized under the Healthcare Insurance Portability and Accountability Act (HIPAA).  These standards were developed in the time period of 2004 and 2005, and NHIA’s Vice President of Health Information Policy Bruce E Rodman represented the interests of the infusion provider community within the X12N group during their development.

We are also expecting the NPRM to propose adoption of the NCPDP Telecommunication Standard vD.Ø and Batch Standard v1.2 for retail pharmacy claims.

If OMB completes its review in its typical time period and approves the draft NPRM without significant changes, we can expect the NPRM to be published next month in the Federal Register for comments.  NHIA will monitor the status and consider comments to submit on behalf of the home infusion community through its Home Infusion EDI Coalition (HIEC) which is chaired by Rodman.  Others interested in participating in development of NHIA comments should contact Rodman at Bruce.Rodman@sbcglobal.net or 847-362-2017.

NHIA members:  find out about other recent developments in health care electronic data interchange that are important to the infusion community in the HIEC News Archives.