On Wednesday, CMS announced that it has delayed the enforcement date for the first two operating rules for HIPAA transaction standards, AHA News reports (AHA News, 1/3).
CMS said that its Jan. 1 compliance deadline for the operating rules remains intact, but it will not begin enforcing the rules until March 31 (Conn, Modern Healthcare, 1/4).
Background
The federal health reform law mandated the development and implementation of new operating rules for HIPAA administrative and financial transactions.
Payers long have used multiple standards for HIPAA transactions and have developed separate guidelines that kept transactions from being uniform (iHealthBeat, 7/5/11).
About the Operating Rules
The operating rules that took effect Jan. 1 relate to HIPAA standards for health plan eligibility and health care claim status (AHA News, 1/3).
The rules affect all HIPAA covered entities, including:
- Claims clearinghouses;
- Health insurers;
- Hospitals; and
- Office-based physicians.
About the Enforcement Delay
In its announcement, CMS said, "Industry feedback suggests that HIPAA covered entities have not reached a threshold whereby a majority of covered entities would be able to be in compliance with the operating rules by Jan. 1." However, the agency added, "This enforcement discretion period does not prevent applicable HIPAA covered entities that are prepared to conduct transactions using the adopted operating rules from doing so."
Despite the delayed enforcement date, CMS said that its Office of E-Health Standards and Services would accept complaints related to compliance with the operating rules starting Jan. 1.
Covered entities that are the subject of complaints might be asked to "produce evidence of either compliance or a good-faith effort to become compliant with the operating rules during the 90-day period," CMS said (Modern Healthcare, 1/4).