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HHS Establishes National Health Plan Identifier (HPID); Delays ICD-10 Transition

September 7, 2012—The Department of Health and Human Services (HHS) Aug. 24 released a final rule establishing a national unique health plan identifier (HPID) that HHS expects to save up to $6 billion over 10 years by creating efficiencies in billing practices. In addition, the rule proposes a data element to identify “other entities” (OEID) involved in transactions. The final rule also delays compliance with ICD-10 diagnosis and procedure codes by one year to Oct. 1, 2014, to allow providers more time to prepare for the transition.

Required by the Affordable Care Act (P.L. 111-148, P.L. 111-152), the HPID will help standardize and automate the process by which electronic transactions are administered under the Health Insurance Portability and Accountability Act of 1996 (HIPAA). By moving to the HPID, HHS expects providers to see a decrease in errors in billing and insurance-related activities.

The final rule requires an organization’s non-covered providers that write prescriptions under the scope of the provider’s relationship with the organization to obtain a national provider identifier (NPI). The provider must also allow any entity that needs the NPI to identify the prescriber in standard transactions.


Evan Collins, MHA
Specialist, Clinical Operations and Policy
Telephone: 202-828-0552


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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