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HHS Issues Interim Final Rule Outlining New Standards for Transmission of Health Care Payment and Processing Information

January 13, 2012—The Department of Health and Human Services (HHS) Jan. 10 released an interim final rule with comment period that requires health plans, health care clearinghouses, and certain health care providers to implement by Jan. 1, 2014, new HIPAA standards for electronic funds transfers (EFT) and notice of payment transactions (known as remittance advice transactions). The changes are an effort to create greater uniformity in data exchange and to help reduce inefficient business processes and costs to providers and insurers.  The interim final rule implements certain administrative simplification provisions of the Affordable Care Act (ACA, P.L. 111-148 and P.L. 111-152).

The rule builds upon regulations issued by HHS in a July 8, 2011 interim final rule requiring payers and providers to adopt standard operating rules intended to make it easier to determine patient insurance eligibility and health care claim status transactions.

According to HHS estimates, the new standards will reduce administrative costs for doctors and hospitals, private health plans, states, and other government health plans by up to $4.5 billion over the next ten years.

HHS will accept comments on the interim final rule through March 12, 2012, and any changes will be finalized no later than Jan. 1, 2013.


Will Dardani
Clinical Policy and Practice Specialist
Telephone: 202-828-0541


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Washington Highlights, a weekly electronic newsletter, features brief updates on the latest legislative and regulatory activities affecting medical schools and teaching hospitals.

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Jason Kleinman
Sr. Legislative Analyst, Govt. Relations
Telephone: 202-903-0806