Suggested Law for Certification of Conformity for Health Plans Revoked by HHS

During January 2014, the Health and Human Services suggested a new law for accreditation of conformity for health strategies. The law would have needed all controlling health plans to present a variety of documents to HHS to show conformity with electronic deal criteria set by the HHS according to HIPAA Laws. The key objective of the suggested rule – Administrative Simplification:
Accreditation of Conformity for Health Strategies – was to encourage more constant testing procedures for controlling health plans. The Health and Human Services has declared that the suggested law has now been revoked.

Had the suggested law made it to the final law stage, CHPs would have been needed to show conformity with HIPAA administration simplification criteria for 3 electronic dealings: Health care claim position, eligibility for a health strategy, and health care electronic funds transfers as well as the transfer of funds advice. The failure to abide by the new rule would have led to financial fines for CHPs.

Most employers’ health policies were managed by their insurance carriers, therefore the suggested law would not have impacted them directly, even though a substantial load would have been put on self-funded companies by the change of law. After publication of the suggested law in the national register during January 2014, HHS got over 72 public remarks. After examining those remarks, the HHS decided to withdraw the suggested law.

HHS will be re-examining the problems raised in the remarks and will be exploring alternatives and options to abide by legal requirements.

The Secretary of the HHS clarified that rules have already been established for conformity with HIPAA administration simplification criteria and enforcement of conformity with those criteria. Although the suggested law has been revoked, the HHS has verified that protected units are still required to abide by 45 CFR parts 160 and 162.