Rule to Tighten EDI Standards in Final Stages
Affordable Care Act mandates adoption of rules regarding HIPAA electronic eligibility verification and claims status.
Insurance Networking News, June 9, 2011
The Department of Health and Human Services has sent to the Office of Management and Budget an interim final rule to adopt operating rules for the HIPAA electronic eligibility verification/benefit determination and claims status transactions.
Transmission to OBM for review and approval is one of the last steps before publication of rules in the Federal Register.
The Affordable Care Act mandates adoption of a series of operating rules to tighten the HIPAA transactions standards between 2013 and 2016, starting with the eligibility and status transactions. The interim final rule would adopt "authoring organizations" to develop the operating rules--presumably the Committee on Operating Rules and the National Council for Prescription Drug Programs as these organizations originated the rules and are working on expansion under the reform law (see story).
This article was reprinteed with permission from Health Data Managment
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