HHS establishes HIPAA standards for Electronic Funds Transfers and Remittance Advice Transactions

In a Jan 5, 2012 press release, the Centers for Medicare & Medicaid Services (CMS) announced that the Department and of Health and Human Services (HHS) has published an interim final rule outlining standards under the Health Insurance Portability and Accountability Act (HIPAA) for Health Care Electronic Funds Transfers (EFT) and Remittance Advice transactions (RA).  

By standardizing and streamlining electronic transactions, CMS projects that the new standards will reduce administrative costs by $4.5 billion for providers, hospitals, and private and government health plans over the next ten years.  Mechanisms for standardization include:

• 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.

CMS anticipates that there will be little to no implementation costs for physician practices and hospitals complying with the new standards.  The interim final rule is effective Jan 1, 2012.  However, HIPAA covered entities must be in compliance with the standards outlined in the rule by Jan 1, 2014.