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Go-to-Info Information Bulletins

Guidance for the HIPAA Administrative Simplification Information Bulletins.

Final

Issued by: Centers for Medicare & Medicaid Services (CMS)

Issue Date: July 29, 2020

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“Go-to-Info” is the short name for HIPAA Administrative Simplification Information Bulletins. Informational Bulletins share information, address operational and technical issues, and highlight best practices, initiatives or related efforts. Informational Bulletins do not establish new policy or provide new guidance.

Information Bulletins

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Federal Register Notice on Requirements for National Plan and Provider Enumeration System (NPPES) Data Changes CMS-0059-N (PDF)
Announces changes to data elements that health care providers are required to submit to the National Plan and Provider Enumeration System (NPPES) to obtain and maintain a National Provider Identifier (NPI).
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Overview of the New Administrative Simplification One Pager (PDF)
Announces a one pager that explains Administrative Simplification requirements, how CMS enforces them, and where users can find additional guidance.
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Proposed Adoption of Standards for Health Care Attachments Transactions, Acknowledgment Transactions, and Electronic Signatures, and Operating Rules for Acknowledgment Transactions, and Modification to Referral Certification and Authorization Transaction Standards (CMS 0053-P) Information Bulletin (PDF)
Announces a proposed rule to adopt standards for health care attachments transactions and standards for electronic signatures to be used in conjunction with health care attachments transactions as well as a modification to the standards for the referral certification and authorization transaction, moving it from the X12 278, Version 5010 to the X12 278, Version 6020.
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Proposed Modifications to the National Council for Prescription Drug Programs Retail Pharmacy Standards and Adoption of a New Pharmacy Subrogation Standard (CMS-0056-P) Information Bulletin (PDF)
Announces a proposed rule to modify the currently adopted National Council for Prescription Drug Programs (NCPDP) Version D.0 standard to the Telecommunications Standard Implementation Guide Version F6 and the equivalent Batch Standard Implementation Guide Version 15.
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Eligibility for a Health Plan Transaction Error Information Bulletin (PDF)
Explains how to properly follow requirements for reporting eligibility and benefits response information.
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Administrative Simplification Reassociation Basics Fact Sheet (PDF)
Announces the release of a new fact sheet on EFT and ERA reassociation and how HIPAA standards and operating rules simplify and streamline the reassociation process.
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2100 Loop Information Bulletin (PDF)
Explains the correct way to utilize the NM1 Corrected Patient/Insured segment on the 2100 Loop of the ASC X12N Version 5010 X 221 Health Care Claim Payment/Advice (835).
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HIPAA Administrative Simplification Regulations Overview (PDF)Announces the release of a new fact sheet on HIPAA Administrative Simplification regulations related to transactions, code sets, unique identifiers, and operating rules, which include provisions designed to streamline and simplify health care transactions..
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Administrative Simplification Basics Fact Sheets (PDF) Announces the release of a series of fact sheets explaining the basics of HIPAA Administrative Simplification transactions and code sets.
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Publication of the D.0 Final Rule (PDF)
Announces the publication of the final rule CMS-0055-F, which modifies the requirements for use of the National Council for Prescription Drug Programs (NCPDP) Telecommunication Standard Implementation Guide, Version D, Release 0, August 2007, by requiring the use of the Quantity Prescribed (460-ET) field to identify partial fills for Schedule II drugs.
Enforcement Statistics Reports (PDF)
Announces the release of revised statistical reports regarding the CMS HIPAA complaint enforcement program.
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Health Plan Identifier Final Rule (PDF)
Announces the publication of Final Rule CMS-0054-F, which eliminates the regulatory requirement for health plans to obtain and use a Health Plan Identifier (HPID) and eliminates the voluntary acquisition and use of the OEID.
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Provider Pilot Program (PDF)
Announces the launch of the volunteer Provider Pilot Program to test the process for reviewing compliance with HIPAA Administrative Simplification rules among providers.
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Compliance Review Program (PDF)
Announces the launch of the Compliance Review Program to ensure compliance among covered entities with HIPAA Administrative Simplification rules for electronic health care transactions.
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Optimization Pilot (PDF)
Announces the completion of the Optimization Pilot, a small-scale effort to recruit volunteer health plans and clearinghouses to submit HIPAA standard transactions to HHS for compliance testing. HHS initiated the Optimization Pilot in preparation for the full-scale Compliance Review Program.
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Modification of the Requirements for the Use of HIPAA National Council for Prescription Drug Programs D.0 Standard (PDF)
Announces the publication of a proposed rule to modify the requirements for the use of the Telecommunication Standard Implementation Guide, Version D, Release 0 (Version D.0), August 2007, National Council for Prescription Drug Programs (NCPDP) by requiring HIPAA covered entities to use the Quantity Prescribed field (460-ET) for retail pharmacy transactions for Schedule II drugs. 
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Health Plan Identifier (HPID) and Other Entity Identifier (OEID) Notice of Proposed Rulemaking (PDF)
Announces the publication of a proposed rule to eliminate the regulatory requirement for health plans to obtain and use an HPID, as well as eliminate the voluntary acquisition and use of the OEID.
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HIPAA Administrative Simplification Information Bulletin (PDF)
Provides an overview of Subregulatory Guidance materials.

Feedback

NSG has created a special mailbox to receive questions, comments and feedback on Guidance Letters, Bulletins, and FAQs, and any other related matters. The address for that mailbox is AdministrativeSimplification@cms.hhs.gov.

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DISCLAIMER: The contents of this database lack the force and effect of law, except as authorized by law (including Medicare Advantage Rate Announcements and Advance Notices) or as specifically incorporated into a contract. The Department may not cite, use, or rely on any guidance that is not posted on the guidance repository, except to establish historical facts.