Pursuant to section 1104 of the Patient Protection and Affordable Care Act (PPACA), the Department of Health and Human Services issued an interim final rule yesterday afternoon adopting operating rules for two Health Insurance Portability and Accountability Act of 1996 (HIPAA) transactions: eligibility for a health plan and health care claim status. HHS adopts, with a few exceptions, the operating rules for these transactions issued by the Council for Affordable and Quality Healthcare’s Committee on Operating Rules for Information Exchange (CAQH CORE), excluding those for retail pharmacy exchanges. This rule also defines the term "operating rules" and explains the role of operating rules in relation to the adopted transaction standards.
The compliance date is January 1, 2013. The interim final rule, which is scheduled for publication in the July 8, 2011 Federal Register, may currently be found at the following web address:
Comments are due by September 6, 2011.