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Facing heavy pressure from industry, HHS rescinds health plan identifier

The Department of Health and Human Services has eliminated the need for health plans to use a standard unique health plan identifier, effective December 27.

The Department of Health and Human Services has eliminated the need for health plans to use a standard unique health plan identifier, effective December 27.

The use of the health plan identifier (HPID) was required in an HHS final rule in 2012 but has never been enforced. Instead, health plans have voluntarily adopted payer IDs based on the National Association of Insurance Commissioners identifier.

Charles Stellar, president and CEO of WEDI—a national group supporting the use of health IT to create efficiencies in information exchange—says WEDI, along with other healthcare industry stakeholders, have played a significant role in guiding “HPID implementation planning.”

“After it became clear in the early years after the rule was issued, that the HPID and its implementation was going to be very complex with little return on investment to the industry, WEDI further engaged the industry, resulting in modifying our comment to support (the idea that) no implementation of HPID was needed, so we applaud the decision by HHS,” Stellar says. In 2017, WEDI began to contend that the HPID was not needed at all.

Earlier this month, WEDI formally applauded the rescinding of the HPID in a published HHS rule.

The final HHS rule eliminates the regulatory requirement for health plans to obtain and use an HPID and eliminates the voluntary acquisition and use of the identifier, according to WEDI. The final rule also simplifies the process for deactivating the existing identifiers to minimize operational costs for covered entities. On or after the effective date of the rule (of December 17), any active HPID or OEID will be automatically deactivated in the Health Plan or Other Entity Enumeration System.

In its comment letter to HHS, the American Hospital Association said it is “fully supportive” of the decision to rescind the HPID and OEID, even calling on HHS to “do so immediately.”

In 2017, AHA called implementation of the HPID “costly, complicated and burdensome disruption.” At that time, AHA agreed with the rationale that there is “no business use case for the HPID/OEID” and that a voluntary model would result in confusion and unnecessary costs to the covered entities that use HIPAA transactions.

The HPID was mandated under the Administrative Simplification provisions of the Health Insurance Portability and Accountability Act of 1996, but HHS proposed to rescind the HPID and “other entity identifier” (OEID) last year, after it received feedback from major health plans, provider associations and vendors, according to Debra McCurdy, senior health policy analyst at Reed Smith.

HHS says it will “explore options for a more effective standard unique health plan identifier,” McCurdy says. “In the meantime, HHS will deactivate each HPID and OEID record in the Health Plan and Other Entity Enumeration System on behalf of each enumerated entity and will communicate to affected organizations and stakeholders about the deactivation process.”

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