HHS Adopts HIPAA Standard for Electronic Funds Transfers/Remittance Advice

CMS today announced an interim final rule with comment period (IFC) under which the Department of Health and Human Services (HHS) adopts standards for the Health Care Electronic Funds Transfers (EFT) and Remittance Advice transaction (RA) under HIPAA. The Patient Protection and Affordable Care Act of 2010 requires CMS to issue a series of regulations over the next five years that are designed to streamline health care administrative transactions, encourage greater use of standards by providers, and make existing standards work more efficiently. On July 8, 2011, CMS published the first regulation, an IFC that puts in place operating rules for two electronic health care transactions that make it easier for providers to determine whether a patient is eligible for coverage and the status of a health care claim submitted to a health insurer. Future administrative simplification rules will address adoption of: A standard unique identifier for health plans; a standard for claims attachments; and requirements that health plans certify compliance with all HIPAA standards and operating rules.