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CMS Announces Delay for Enforcing HIPAA Claims Standards

January 4, 2013
by Rajiv Leventhal
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The Centers for Medicare & Medicaid Services' (CMS) Office of E-Health Standards and Services (OESS) announced this week that HIPAA-covered entities will have an extra 90 days to comply with operating rules for checking eligibility for health plan coverage and the status of healthcare claims electronically.

CMS said that its original January 1 compliance deadline for the operating rules remains intact, but it will not begin enforcing the rules until March 31. According to OESS, the delay is due to industry feedback suggesting that most entities would not be able to be in compliance with the operating rules by its original deadline.  

“This enforcement discretion period does not prevent applicable HIPAA-covered entities that are prepared to conduct transactions using the adopted operating rules from doing so, and all applicable covered entities are encouraged to determine their readiness to use the operating rules as of January 1, 2013 and expeditiously become compliant,” CMS said in its statement.

Although enforcement action will not be taken, OESS will accept complaints associated with compliance with the operating rules starting this month. If requested by OESS, covered entities that are the subject of complaints (known as “filed-against entities”) must produce evidence of either compliance or a good faith effort to become compliant with the operating rules during the 90-day period.

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