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HIPAA Information
This section contains information for the public about the Health Insurance Portability
and Accountability Act of 1996 as it relates to the pharmacy industry. Subsections
include information on
| HIPAA Transactions | |
| Official Date of Final Rule: | January 16, 2009 |
| Effective Date of Regulation (except Subrogation): | March 17, 2009 |
| Effective Date of Regulation (Subrogation): | January 1, 2010 |
| Compliance Date (5010, D.0 – all industry): | January 1, 2012 |
| Compliance Date (Subrogation only – all appropriate except Small Health Plans): | January 1, 2012 |
| Compliance Date for Small Health Plans (Subrogation only): | January 1, 2013 |
| Electronic Funds Transfers (EFTs) and Remittance Advice | |
| Publication Date: | January 10, 2012 |
| Effective Date of Regulation: | January 10, 2012 |
| Compliance Date: | January 1, 2014 |
| ICD-10 | |
| Official Date of Final Rule: | January 16, 2009 |
| Effective Date of Regulation: | March 17, 2009 |
| Compliance Date: | October 1, 2014 |
| Operating Rules | |
| Eligibility and Claims Status transactions | |
| Publication Date: | July 8, 2011 |
| Effective Date of Regulation: | June 30, 2011 |
| Compliance Date: | January 1, 2013 |
| Health Care Electronic Funds Transfers and Remittance Advice transactions | |
| Publication Date: | August 10, 2012 |
| Effective Date of Regulation: | August 10, 2014 |
| Compliance Date: | January 1, 2013 |
| Health Plan Identifier | |
| Publication Date: | September 9, 2012 |
| Effective Date of Regulation: | November 5, 2012 |
| Compliance Date for all health plans (to obtain HPID) except small health plans: | November 5, 2014 |
| Compliance Date for small health plans (to obtain HPID): | November 5, 2015 |
| Use of HPIDs in standard transactions on or after: | November 7, 2016 |
Health Plan Identifier (HPID)
HHS final rule (2012-21238) effective on November 5, 2012. Compliance dates: Health plans with the exception of small health plans must obtain an HPID by November 5, 2014. Small health plans must obtain an HPID by November 5, 2015. Covered entities must use HPIDs in the standard transactions on or after November 7, 2016.
Final Rule Correction
CMS Guidance & Webinars
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