Federal Regulation & Notices
Guidance for a final rule adopting X12 Version 5010 and NCPDP Version D.0. for HIPAA transactions and a new standard for Medicaid subrogation for pharmacy claims, known as NCPDP Version 3.0.
Final
Issued by: Centers for Medicare & Medicaid Services (CMS)
Issue Date: July 27, 2012
On January 16, 2009, HHS published a final rule adopting X12 Version 5010 and NCPDP Version D.0. for HIPAA transactions.
The compliance dates for Version 5010 and Version D.0. for all covered entities, is January 1, 2012. This gives the industry time to test the standards internally to ensure that systems have been appropriately updated, and then to test with trading partners before the compliance date.
The January 16, 2009 Final Rule also adopted a new standard for Medicaid subrogation for pharmacy claims, known as NCPDP Version 3.0. The compliance date for the Medicaid subrogation standard (Version 3.0) is also January 1, 2012, except for small health plans, which will have until January 1, 2013 to come into compliance.
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