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HPID Requirement Update – A Treat, Without a Trick

Employee Benefits Law Alert John L. Barlament

On Friday, October, 31, 2014, the federal government delayed a November 5, 2014 health plan identifier deadline that had been a significant concern to many large employers. Specifically, the Centers for Medicare & Medicaid Services (CMS), the division of the Department of Health & Human Services (HHS) that is responsible for enforcement of certain HIPAA requirements, including the standard transaction requirements, gave the procrastinators among us a Halloween treat: CMS announced that it will delay, until further notice, the requirement that large health plans obtain a health plan identifier (HPID) by November 5, 2014 and that HIPAA covered entities (health plans, healthcare providers and clearinghouses, and their business associates) use the HPID in HIPAA transactions.

CMS stated that this delay will allow HHS to review recommendations from the National Committee on Vital and Health Statistics (NCVHS), an advisory body to HHS, that HHS rectify in rulemaking that all HIPAA covered entities not use the HPID in the HIPAA transactions.

  Q&B Key: The delay makes sense and is a welcome relief. The NCVHS findings -- from May, June and September of this year -- are essentially that the HPID requirement is unnecessary and that the HPID will not be used for HIPAA standard transactions. The HPID may still be used for other purposes, but this is speculative. Unless CMS finds that there really are other justifications for an HPID, we may have just witnessed the end of the HPID requirement.

Small health plans already had an additional year, until November 5, 2015, to obtain an HPID. Presumably, if and when CMS provides guidance on the HPID requirements in the future, it will also address timing for small health plans.

For more information on the HPID requirements, visit the CMS HPID website or contact the authors of this alert, Amy A. Ciepluch at (414) 277-5585[email protected] or John L. Barlament at (414) 277-5727[email protected], or your local Quarles & Brady attorney. The NCVHS guidance on the HPID is available here: