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HPID Final Rule

Guidance for the HPID final rule.


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

Issue Date: August 03, 2020

HPID Final Rule

The Department of Health & Human Services (HHS) has published in the Federal Register the Final Rule CMS-0054-F pertaining to the Administrative Simplification provisions of the Health Insurance Portability and Accountability Act of 1996 (HIPAA). 

HIPAA required that HHS adopt a national plan identifier, with the intent of improving the utility of HIPAA transactions and reducing burden and costs. Standards for a national HPID and an OEID were adopted through a final rule on September 5, 2012 (77 FR 54664). Following publication of the final rule, HHS received feedback from stakeholders and the National Committee on Vital and Health Statistics (NCVHS) regarding provider burden, implementation costs, and inefficiencies. On October 31, 2014, HHS announced an enforcement discretion, meaning covered entities would not be penalized for non-compliance with the HPID final rule. 

On December 18, 2018, HHS published a proposed rule to rescind the HPID and OEID based on additional input from NCVHS and industry stakeholders. There was a 60-day public comment period for the NPRM, which closed on February 19, 2019.  The proposed rule can be found here.  After receiving supporting comments in response to the provisions in the NPRM, the rule was adopted as proposed. 

This final rule eliminates the regulatory requirement for health plans to obtain and use an HPID and eliminates the voluntary acquisition and use of the OEID. The final rule also simplifies the process for deactivating the existing identifiers to minimize operational costs for covered entities. On or after the effective date of this final rule, any active HPID or OEID will be automatically deactivated in the Health Plan and Other Entity Enumeration System (HPOES). If your organization has an HPID or OEID, please take action now to save any necessary information from those records. This rule will become effective 60 days after its publication date.


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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.